Provider Demographics
NPI:1528515558
Name:RASCO, JACQUELINE (MHP)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:RASCO
Suffix:
Gender:F
Credentials:MHP
Other - Prefix:MRS
Other - First Name:JACQUELINE
Other - Middle Name:DUNKLEY
Other - Last Name:RASCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHP
Mailing Address - Street 1:712 FIRST ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-2421
Mailing Address - Country:US
Mailing Address - Phone:318-878-6696
Mailing Address - Fax:318-878-6698
Practice Address - Street 1:712 FIRST ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232
Practice Address - Country:US
Practice Address - Phone:318-878-6696
Practice Address - Fax:318-878-6698
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2018-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator