Individual
MRS. JENNIFER ALANE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C, LICSW
Contact information
Practice address
200 WOOD HILL RD, ROCKVILLE, MD 20850-8724
(301) 838-4200
Mailing address
200 WOOD HILL RD, ROCKVILLE, MD 20850-8724
(301) 838-4200
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17943
MD
1041C0700X
Clinical Social Worker
LC50079244
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12455520
CAQH
MD
Enumeration date
11/26/2012
Last updated
12/02/2021
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