Provider Demographics
NPI:1538734959
Name:CORSINI, JACQUELINE KENNEDY (MS, NCC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:KENNEDY
Last Name:CORSINI
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 KILBURN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-1607
Mailing Address - Country:US
Mailing Address - Phone:302-367-4366
Mailing Address - Fax:
Practice Address - Street 1:703 KILBURN RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-1607
Practice Address - Country:US
Practice Address - Phone:302-367-4366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health