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Individual

MRS. JALETHA JENKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LBSW

Contact information

Practice address
2004 FREMONT ST, SOUTH BEND, IN 46628-3153
(317) 296-5382
Mailing address
6101 N KEYSTONE AVE STE 100, INDIANAPOLIS, IN 46220-2499
(317) 296-5382

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
33900285A
IN
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
09/05/2023
Last updated
09/05/2023
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