Individual
JACQUELINE LOCROTONDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1465 LANEY WALKER BLVD PAVILION II AF 1040, AUGUSTA, GA 30912-0004
(706) 721-3448
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
80820
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/06/2015
Last updated
11/22/2019
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