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Individual

JENNIFER W. JENCKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1000
(401) 432-1500
Mailing address
1011 VETERANS MEMORIAL PARKWAY, EAST PROVIDENCE, RI 02915-5061
(401) 432-1000
(401) 432-1500

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01282
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ISW01282
PROFESSIONAL LICENSE
RI
Enumeration date
10/08/2012
Last updated
10/08/2012
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  • EDI platform