Individual
MS. CLANCEY JACKSON PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
16 CLARKE ST, LEXINGTON, MA 02421-4988
(781) 402-2442
(781) 402-1744
Mailing address
2 PORTER AVE, METHUEN, MA 01844-6228
(603) 247-0386
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
113247
MA
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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