Individual
ELAINE JAE PENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LSCSW
Contact information
Practice address
2320 BRETT DR, LAWRENCE, KS 66049-1675
(785) 813-2760
Mailing address
2320 BRETT DR, LAWRENCE, KS 66049-1675
(785) 813-2760
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2536
KS
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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