Individual
JENNIFER LYNN FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
121 W MAIN ST, PORT WASHINGTON, WI 53074-1813
(262) 284-8200
(262) 284-8104
Mailing address
121 W MAIN ST, PORT WASHINGTON, WI 53074-1813
(262) 284-8200
(262) 284-8104
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6850-120
WI
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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