Individual
JEFFREY LANCE PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
860 E RIVER PL STE 100, JACKSON, MS 39202-3442
(769) 251-5550
Mailing address
860 E RIVER PL STE 100, JACKSON, MS 39202-3442
(769) 251-5550
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M7738
MS
Other
Enumeration date
03/12/2020
Last updated
03/12/2020
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