Provider Demographics
NPI:1194741736
Name:JEFFREYS, JACQUELINE D (PSYS)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:D
Last Name:JEFFREYS
Suffix:
Gender:F
Credentials:PSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1208
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81402
Mailing Address - Country:US
Mailing Address - Phone:970-874-8981
Mailing Address - Fax:970-874-8989
Practice Address - Street 1:195 STAFFORD LN
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416
Practice Address - Country:US
Practice Address - Phone:970-874-8981
Practice Address - Fax:970-874-4169
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health