Healthcare Provider Details

I. General information

NPI: 1548570690
Provider Name (Legal Business Name): JACQUELINE A. FOLEY MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 VIGO ST
VINCENNES IN
47591-2832
US

IV. Provider business mailing address

702 VIGO ST PO BOX 702
VINCENNES IN
47591-2832
US

V. Phone/Fax

Practice location:
  • Phone: 812-882-0509
  • Fax: 812-895-0585
Mailing address:
  • Phone: 812-882-0509
  • Fax: 812-895-0585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: