Individual
MRS. JENNIFER LYNN LOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W., LCSW
Contact information
Practice address
5659 S STATE ROAD 61, WINSLOW, IN 47598-8489
(812) 789-5434
(812) 789-2458
Mailing address
823 W SHEPHERDS LN, SANTA CLAUS, IN 47579-6325
(812) 544-3469
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
34004083A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000504591
ANTHEM PIN NUMBER
IN
01
—
11253576
CAQH NUMBER
IN
Enumeration date
05/19/2006
Last updated
03/25/2008
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