Provider Information for 1518053776
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Ms. JACKIE DOWNIE LCSW
Other Names:Professional Name:JACKIE DOWNIE MSWSex: Female
NPI: 1518053776
Last Updated: 2019-01-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1518053776 | ||||||||||||||||
| Enumeration Date | 2006-10-05 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | PO BOX 484 PINEDALE, WY 82941-0484 United States Phone: 307-367-4118 | Fax: | ||||||||||||||||
| Primary Practice Address | 219 EAST PINE STREET SUITE 104 PINEDALE, WY 82941-0484 United States Phone: 307-367-4118 | Fax: | ||||||||||||||||
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