Individual
JENNIFER E CONSOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
4905 LANTANA RD, LAKE WORTH, FL 33463-6915
(561) 340-7269
Mailing address
4905 LANTANA RD, LAKE WORTH, FL 33463-6915
(561) 340-7269
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ISW10874
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ISW10874
—
FL
Enumeration date
12/09/2021
Last updated
12/09/2021
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