Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | G04934 | MD |
NPI | 1144455841 |
---|---|
Provider Name | Ms. Barbara Ann Jaquette |
First Address | Silver Spring, MD 20901-1904 |
Second Address | Ellicott City, MD 21042-3920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2009 |
Last Update Date | 25/05/2009 |