Individual
ELISABETH JEAN-JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
7903 ORION CIR APT H240, LAUREL, MD 20724-3101
(352) 219-4969
Mailing address
7903 ORION CIR APT H240, LAUREL, MD 20724-3101
(352) 219-4969
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003762
GA
Other
Enumeration date
10/16/2016
Last updated
10/16/2016
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