Individual
JENNIFER ALICE MANDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCISW
Contact information
Practice address
124 E SHORT AVE, SPOKANE, WA 99202-1555
(509) 838-4651
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW61307762
WA
1041C0700X
Clinical Social Worker
SC61003412
WA
390200000X
Student in an Organized Health Care Education/Training Program
CG60930980
WA
Other
Enumeration date
09/07/2016
Last updated
11/16/2022
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