Individual
JESSICA L JACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, MSW
Contact information
Practice address
2600 HUMES RD STE 100, JANESVILLE, WI 53545-0491
(608) 741-2117
(608) 758-5761
Mailing address
2600 HUMES RD STE 100, JANESVILLE, WI 53545-0491
(608) 741-2117
(608) 758-5761
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
129191-121
WI
1041C0700X
Clinical Social Worker
Primary
9310-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699143909
—
WI
Enumeration date
09/03/2015
Last updated
12/03/2019
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