Individual
JENNIFER MACCORQUODALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1626 OCONNELL BLVD BLDG 1525, FT CARSON, CO 80913-4060
(719) 524-4671
Mailing address
1626 OCONNELL BLVD, BLDG 813, FT CARSON, CO 80913-4060
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
501
CO
Other
Enumeration date
01/12/2010
Last updated
08/05/2025
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