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Individual

JESSICA RENEE NISSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2845 INDEPENDENCE ST, CAPE GIRARDEAU, MO 63703-5015
(573) 803-5002
Mailing address
1521 N CLARK ST, CAPE GIRARDEAU, MO 63701-2957
(573) 210-8338

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2019019923
MO

Other

Enumeration date
10/22/2019
Last updated
11/27/2023
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