Provider Demographics
NPI:1235611104
Name:WINSLOW, JACQUELINE ST GEORGE
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ST GEORGE
Last Name:WINSLOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ROCK ST FL 1
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3138
Mailing Address - Country:US
Mailing Address - Phone:508-678-7542
Mailing Address - Fax:508-646-0618
Practice Address - Street 1:101 ROCK ST FL 1
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3138
Practice Address - Country:US
Practice Address - Phone:508-678-7542
Practice Address - Fax:508-646-0618
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical