Organization
JACQUELINE JAFFE O'DUOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE JAFFE O'DUOR LCSW (LICENSED CLINICAL SOCIAL WORKR)
(267) 329-9393
Entity
Organization
Contact information
Practice address
2305 FAIRMOUNT AVE, PHILADELPHIA, PA 19130-2515
(267) 329-9393
Mailing address
5109 KINGSESSING AVE, SUITE 2, PHILADELPHIA, PA 19143-4327
(267) 329-9393
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
017676
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12535207
CAQH ID
PA
Enumeration date
03/31/2016
Last updated
03/31/2016
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