Individual
JENNIFER LUCY OTWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
114 MAPLE AVE, TRUSSVILLE, AL 35173-1415
(205) 283-7112
Mailing address
114 MAPLE AVE, TRUSSVILLE, AL 35173-1415
(205) 283-7112
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1615-4225C
AL
Other
Enumeration date
12/02/2021
Last updated
12/02/2021
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