Provider Demographics
NPI:1104251750
Name:MACLEOD, JACQUELYN F
Entity type:Individual
Prefix:MRS
First Name:JACQUELYN
Middle Name:F
Last Name:MACLEOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23A PLAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-2412
Mailing Address - Country:US
Mailing Address - Phone:508-345-2816
Mailing Address - Fax:
Practice Address - Street 1:23A PLAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:MA
Practice Address - Zip Code:02370-2412
Practice Address - Country:US
Practice Address - Phone:508-345-2816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator