Individual
JENNIFER MYSOGLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6330 E 75TH ST, SUITE 300, INDIANAPOLIS, IN 46250-2777
(317) 577-5948
(317) 577-5954
Mailing address
1956 SUMMERSWEET LN, CARMEL, IN 46033-9247
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005721A
IN
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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