Individual
MRS. JENNIFER ROSE BANAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
135 E 38TH ST, ERIE, PA 16504-1559
(814) 860-2639
Mailing address
1326 ROBIN RD S, ST PETERSBURG, FL 33707-3829
(740) 993-9246
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW015449
PA
1041C0700X
Clinical Social Worker
I.1440290-SUPV
OH
Other
Enumeration date
10/16/2006
Last updated
04/07/2023
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