Individual
AMY JAQUITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 E 3RD ST, JAMESTOWN, NY 14701-5433
(716) 661-8330
(716) 753-4230
Mailing address
7 N ERIE ST, MAYVILLE, NY 14757-1095
(716) 753-4104
(716) 753-4230
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19319
NY
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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