Basic Information
Provider Information
NPI: 1013589225
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OQUINN
FirstName: JOCELYN
MiddleName: ANN
NamePrefix: MS.
NameSuffix:  
Credential: MFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 64 BAGDAD RD
Address2:  
City: DURHAM
State: NH
PostalCode: 038243218
CountryCode: US
TelephoneNumber: 6033977604
FaxNumber:  
Practice Location
Address1: 33 WARREN ST
Address2:  
City: CONCORD
State: NH
PostalCode: 033014049
CountryCode: US
TelephoneNumber: 6032261999
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/15/2021
LastUpdateDate: 07/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X  Y Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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