Individual
ANGELA JEAN FENSKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1530 S MAIN ST, JOPLIN, MO 64804-0750
(417) 437-4329
Mailing address
13050 HICKORY DR, NEOSHO, MO 64850
(417) 437-4329
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2009008980
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326270257
—
MO
Enumeration date
08/11/2009
Last updated
01/06/2016
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