Provider Information for 1417388927
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Mrs. JACQUELINE MAJ BAIADA Msw, LCSW
Sex: Female
NPI: 1417388927
Last Updated: 2013-12-09
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1417388927 | ||||||||
| Enumeration Date | 2013-12-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1001 REYNOLDA ROAD WINSTON SALEM, NC 27104 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 1001 REYNOLDA RD WINSTON SALEM, NC 27104-3245 United States Phone: 336-728-4362 | Fax: | ||||||||
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