Individual
JESSICA MARIA NANZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DSW, LCSW, BCD
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 461-0570
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 461-0570
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10157
TN
104100000X
Social Worker
Primary
C010575
NC
1041C0700X
Clinical Social Worker
C010575
NC
Other
Enumeration date
07/25/2014
Last updated
09/08/2023
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