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Individual

MS. JENNIFER ANN ITSKOVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
700 COMMERCE DR STE 255, WOODBURY, MN 55125-5406
(651) 714-3848
(651) 344-0820
Mailing address
10634 E RIVERSIDE DR STE 130, BOTHELL, WA 98011-3758
(425) 821-5021
(425) 821-7968

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LW00009171
WA
1041C0700X
Clinical Social Worker
Primary
20368
MN

Other

Enumeration date
05/17/2007
Last updated
09/30/2022
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