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Organization

MICHELLE JAQUISH

Active
Other names
Banshee Therapy Services
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE N JAQUISH (SOLE OWNER)
(541) 626-6356
Entity
Organization

Contact information

Practice address
6314 19TH ST W STE 7, FIRCREST, WA 98466-6223
(601) 207-8735
Mailing address
6314 19TH ST W STE 7, FIRCREST, WA 98466-6223
(601) 207-8735

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
07/19/2022
Last updated
01/13/2025
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