Most Relevant Information
Provider Data
| NPI Number: | 1003547183 |
| Provider Name: | CHRISTIE JACQUES |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 37PC00598400 |
Most Important Dates
| Enumeration Date: | 06/21/2022 |
| Last Updated: | 06/21/2022 |
Provider Practice Location
165 RICHARD CT
POMONA
NY
109702307
Practice Location Phone/Fax
| Phone: | 8456422566 |
| Fax: |
Provider Mailing Location
165 RICHARD CT
POMONA
NY
109702307
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |