Individual
JENNIFER N LO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
19 UNION SQ W, NEW YORK, NY 10003-3304
(212) 627-9600
(212) 627-4040
Mailing address
23 INGRAHAM ST APT 1R, BROOKLYN, NY 11206-3532
(212) 627-9600
(212) 627-4040
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
074752
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074752
LMSW LICENSE
NY
Enumeration date
05/22/2007
Last updated
01/16/2014
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