Individual
MS. JENNIFER LYNN MOTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
603 N WAYNE ST, ANGOLA, IN 46703-1081
(260) 668-8797
(260) 665-1620
Mailing address
PO BOX 98, 603 N. WAYNE STREET, ANGOLA, IN 46703-0098
(260) 668-8797
(260) 665-1620
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
34005718A
IN
1041C0700X
Clinical Social Worker
Primary
34005718A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200846380 A
—
IN
Enumeration date
03/27/2007
Last updated
11/03/2009
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