| Jacqueline Jaffe O'duor, Llc | |
|
2305 Fairmount Ave Philadelphia PA 19130-2515 | |
| (267) 329-9393 | |
| Not Available |
| Full Name | Jacqueline Jaffe O'duor, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2305 Fairmount Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Jacqueline Jaffe O'duor (LICENSED CLINICAL SOCIAL WORKR) |
| Authorized Official Contact | 2673299393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline Jaffe O'duor, Llc 5109 Kingsessing Ave Suite 2 Philadelphia PA 19143-4327 Ph: (267) 329-9393 | Jacqueline Jaffe O'duor, Llc 2305 Fairmount Ave Philadelphia PA 19130-2515 Ph: (267) 329-9393 |
| NPI Number | 1639532237 |
|---|---|
| Provider Enumeration Date | 03/31/2016 |
| Last Update Date | 03/31/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639532237 | NPI | - | NPPES |
| 12535207 | Other | PA | CAQH ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 017676 (Pennsylvania) | Primary |
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