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Individual
JEANNY MASSO
Active
Individual
JEANNY MASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
149025540
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811583453
—
IL
Enumeration date
12/17/2020
Last updated
05/04/2023
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