Individual
MS. JACQUELINE ANN O'CONNELL-BAGNATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
45 PINE ST, 1 MDOS SGOH, HAMPTON, VA 23665-2025
(757) 764-6840
Mailing address
77 NEALY AVENUE, 633D MEDICAL GROUP, JOINT BASE LANGLEY-EUSIS, VA 23665-2040
(757) 764-6840
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003411
VA
1041C0700X
Clinical Social Worker
LCSW - 12020
AZ
Other
Enumeration date
12/19/2006
Last updated
03/19/2018
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