Individual
JENNIFER ANN VLACOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
40 FAIRBANK RD STE C, SUDBURY, MA 01776-5609
(978) 639-3208
Mailing address
40 FAIRBANK RD STE C, SUDBURY, MA 01776-5609
(978) 639-3208
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
113408
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113408
LICSW (SOCIAL WORK LICENSE)
MA
Enumeration date
05/07/2018
Last updated
05/07/2018
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