Henry, Jacqueline
Henry, Jacqueline is an individual health care provider with primary practice located at 3702 W Truman Blvd Suite 115, Jefferson City MO 65109-4970. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Henry, Jacqueline can be contacted via phone (573) 634-5303.Contact Information
Primary practice address
3702 W Truman Blvd Suite 115
Jefferson City MO 65109-4970
Phone: (573) 634-5303
Fax: (573) 761-6888
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 33758 | Missouri |
Profile Details
| NPI number | 1962448696 |
|---|---|
| LBN Legal business name | Henry, Jacqueline |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962448696 | NPPES |
| Missouri | Other | 33758 | STATE LICENSES |
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