Provider Demographics
NPI:1700471893
Name:YARBROUGH, JACQUELINE RENE' (SOCIAL WORKER)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:RENE'
Last Name:YARBROUGH
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3936 TORREY PINES CIR APT 203
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-2421
Mailing Address - Country:US
Mailing Address - Phone:901-601-2911
Mailing Address - Fax:
Practice Address - Street 1:3936 TORREY PINES CIR APT 203
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-2421
Practice Address - Country:US
Practice Address - Phone:901-601-2911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker