Individual
JESSICA WACLAWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
51 EAGLE RD, EAGLE-VAIL, CO 81620
(303) 717-0801
Mailing address
PO BOX 1776, AVON, CO 81620-1776
(303) 717-0801
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
CO
Other
Enumeration date
03/01/2016
Last updated
03/01/2016
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