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Individual

DEENAH JACQUES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
328 MAIN ST, SOUTHBRIDGE, MA 01550-3794
(508) 765-9101
Mailing address
43 PARK TERRACE RD APT 1, WORCESTER, MA 01604-5462

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
07/15/2019
Last updated
07/15/2019
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