Individual
JENNIFER LYNN SOUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
3690 GRANT DR STE I, RENO, NV 89509-5360
(775) 386-8755
Mailing address
6155 PLUMAS ST APT 209, RENO, NV 89519-6043
(775) 515-5137
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8389-S
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346717725
—
NV
Enumeration date
01/20/2020
Last updated
01/20/2020
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