Most Relevant Information
Provider Data
| NPI Number: | 1003424805 |
| Provider Name: | JACQUELINE WALTER LICSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 122769 |
Most Important Dates
| Enumeration Date: | 07/17/2020 |
| Last Updated: | 07/17/2020 |
Provider Practice Location
55 FRUIT ST
BOSTON
MA
021142621
Practice Location Phone/Fax
| Phone: | 6177262000 |
| Fax: |
Provider Mailing Location
55 FRUIT ST
BOSTON
MA
021142696
Provider Mailing Phone/Fax
| Phone: | 6177262000 |
| Fax: |