Individual
HEIDI JAMMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1125 6TH ST SW, WILLMAR, MN 56201-3432
(320) 235-4613
Mailing address
1125 6TH ST SW, WILLMAR, MN 56201-3432
(320) 235-4613
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17902
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LICSW 17902
MN STATE LICENSE
MN
Enumeration date
07/15/2015
Last updated
07/15/2015
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