Individual
JACQUELINE ELIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 SUMMER ST, 104, TAUNTON, MA 02780-3469
(508) 207-8819
Mailing address
35 SUMMER ST, 104, TAUNTON, MA 02780-3469
(508) 207-8819
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093787095
—
MA
Enumeration date
09/28/2016
Last updated
09/28/2016
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