Pepper, Jacqueline

Pepper, Jacqueline is an sole proprietor health care provider with primary practice located at 1007 N College Ave St. 1, Columbia MO 65201-4794. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Pepper, Jacqueline can be contacted via phone (573) 214-2253.

Contact Information

Primary practice address
1007 N College Ave St. 1 Columbia MO 65201-4794
Phone: (573) 214-2253
Fax: (573) 474-5683
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW005246 Missouri

Profile Details

NPI number 1225021728
LBN Legal business name Pepper, Jacqueline
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2005
Last updated Jul 12th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225021728 NPPES
Missouri MEDICAID 498301332
Missouri MEDICAID 753424407
Missouri Other 24647036

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