Provider Information for 1962500744
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Ms. DAPHNE LYNN JAKSTIS LICSW
Sex: Female
NPI: 1962500744
Last Updated: 2017-04-13
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1962500744 | ||||||||||||
| Enumeration Date | 2006-09-20 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 48 S FRANKLIN ST DALLASTOWN, PA 17313-2006 United States Phone: 508-274-3831 | Fax: | ||||||||||||
| Primary Practice Address | 3088 CRANBERRY HWY EAST WAREHAM, MA 02538-4800 United States Phone: 508-295-7990 | Fax:508-295-3781 | ||||||||||||
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