Individual
JAQUISE WHITEHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
1308 N MAIN ST, CROWN POINT, IN 46307-2719
(219) 663-6353
Mailing address
1308 N MAIN ST, CROWN POINT, IN 46307-2719
(219) 663-6353
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
99116797A
IN
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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