Individual
MS. CAROL J JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LCSW
Contact information
Practice address
505 SOUTH 22ND ST, PHILADELPHIA, PA 19146
(215) 735-1839
(610) 771-0887
Mailing address
505 SOUTH 22ND ST, PHILADELPHIA, PA 19146
(215) 735-1839
(610) 771-0887
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW000827L
PA
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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