Most Relevant Information
Provider Data
| NPI Number: | 1003658998 |
| Provider Name: | JACLYN WILLEMAIN LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/11/2024 |
| Last Updated: | 06/11/2024 |
Provider Practice Location
1071 NORTH ST
SUFFIELD
CT
060781629
Practice Location Phone/Fax
| Phone: | 4133308023 |
| Fax: |
Provider Mailing Location
1071 NORTH ST
SUFFIELD
CT
060781629
Provider Mailing Phone/Fax
| Phone: | 4133308023 |
| Fax: |