| Jacqueline C Ekstrom Lcsw Llc | |
|
1103 9th Ave W Bradenton FL 34205-7717 | |
| (941) 218-0061 | |
| Not Available |
| Full Name | Jacqueline C Ekstrom Lcsw Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1103 9th Ave W, Bradenton, Florida |
| Authorized Official Name and Position | Jacqueline C Ekstrom (OWNER) |
| Authorized Official Contact | 9412180061 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline C Ekstrom Lcsw Llc 4207 5th Ave Ne Bradenton FL 34208-5000 Ph: () - | Jacqueline C Ekstrom Lcsw Llc 1103 9th Ave W Bradenton FL 34205-7717 Ph: (941) 218-0061 |
| NPI Number | 1528527231 |
|---|---|
| Provider Enumeration Date | 03/13/2019 |
| Last Update Date | 03/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528527231 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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