Provider Demographics
NPI:1497851216
Name:DION, JACQUELINE M (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:M
Last Name:DION
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PARADE RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03037-1202
Mailing Address - Country:US
Mailing Address - Phone:603-391-2495
Mailing Address - Fax:
Practice Address - Street 1:718 SMYTH RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-7004
Practice Address - Country:US
Practice Address - Phone:603-624-4366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical