Provider Demographics
NPI:1700939154
Name:SEGUE-WILKINS, JACQUELINE MARIE (LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:MARIE
Last Name:SEGUE-WILKINS
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 TWIN KNOLLS RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3257
Mailing Address - Country:US
Mailing Address - Phone:410-884-2848
Mailing Address - Fax:410-884-2849
Practice Address - Street 1:5401 TWIN KNOLLS RD
Practice Address - Street 2:SUITE 9
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3257
Practice Address - Country:US
Practice Address - Phone:410-884-2848
Practice Address - Fax:410-884-2849
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral