Organization
JENNIFER PATRICK, LCSW, LIMITED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER MICHELE PATRICK LCSW (SOLE-PROPRIETOR)
(573) 642-2102
Entity
Organization
Contact information
Practice address
2625 FAIRWAY DR, STE. A, FULTON, MO 65251-4023
(573) 642-2102
Mailing address
2625 FAIRWAY DR, STE. A, FULTON, MO 65251-4023
(573) 642-2102
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831182427
NPI
MO
Enumeration date
10/26/2010
Last updated
11/05/2010
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