Individual
MRS. JODI NISWONGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
7040 LAREDO ST, SUITE D, LAS VEGAS, NV 89117-3000
(702) 898-5311
(702) 898-5310
Mailing address
6502 AFFERMATO ST, LAS VEGAS, NV 89131-3147
(702) 207-4469
(702) 898-5310
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5436-C
NV
Other
Enumeration date
08/18/2008
Last updated
08/18/2008
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