Provider Demographics
NPI:1548570690
Name:FOLEY, JACQUELINE A (MS)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:A
Last Name:FOLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 VIGO ST
Mailing Address - Street 2:PO BOX 702
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-2832
Mailing Address - Country:US
Mailing Address - Phone:812-882-0509
Mailing Address - Fax:812-895-0585
Practice Address - Street 1:702 VIGO ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-2832
Practice Address - Country:US
Practice Address - Phone:812-882-0509
Practice Address - Fax:812-895-0585
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker