Provider Demographics
NPI:1982052916
Name:BOCCHER, JACQUELINE (LSW)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:BOCCHER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1319
Mailing Address - Country:US
Mailing Address - Phone:908-782-7905
Mailing Address - Fax:908-782-5934
Practice Address - Street 1:6 PARK AVE
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1319
Practice Address - Country:US
Practice Address - Phone:908-782-7905
Practice Address - Fax:908-782-5934
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05922500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker