Provider Demographics
NPI:1700235389
Name:EASTON, JACQUELINE
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:
Last Name:EASTON
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 1:4451 PARLIAMENT PLACE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706
Mailing Address - Country:US
Mailing Address - Phone:301-577-4333
Mailing Address - Fax:
Practice Address - Street 1:4451 PARLIAMENT PLACE
Practice Address - Street 2:SUITE A
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:301-577-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst