Individual
JENNIFER LYN WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
202 W FAIRVIEW AVE, JOHNSON CITY, TN 37604-5611
(423) 439-7371
Mailing address
202 W FAIRVIEW AVE, JOHNSON CITY, TN 37604-5611
(423) 439-7371
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW0000010776
TN
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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