Provider Demographics
NPI:1851739353
Name:DAQUIN, JEWELLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JEWELLE
Middle Name:
Last Name:DAQUIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7230 HERITAGE VILLAGE PLZ STE 202
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3054
Mailing Address - Country:US
Mailing Address - Phone:703-754-0636
Mailing Address - Fax:
Practice Address - Street 1:7230 HERITAGE VILLAGE PLZ STE 202
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3054
Practice Address - Country:US
Practice Address - Phone:703-754-0636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005452101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional