Individual
JACQUELINE DE CORMIER BEAULIEU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 VFW PKWY, MAIL STOP A-122, WEST ROXBURY, MA 02132-4927
(857) 203-5176
Mailing address
1400 VFW PKWY, MAIL STOP A-122, WEST ROXBURY, MA 02132-4927
(857) 203-5176
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
1165096
MA
104100000X
Social Worker
Primary
122139
MA
104100000X
Social Worker
222460
MA
1041C0700X
Clinical Social Worker
122139
MA
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
01/09/2017
Last updated
03/05/2020
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