Provider Demographics
NPI:1366601627
Name:JENKINS, JACQUELYN (MSW)
Entity type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 INDIA BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-6785
Mailing Address - Country:US
Mailing Address - Phone:386-860-4534
Mailing Address - Fax:386-860-4534
Practice Address - Street 1:3024 INDIA BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-6785
Practice Address - Country:US
Practice Address - Phone:386-860-4534
Practice Address - Fax:386-860-4534
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator