Individual
JENNIFER R PFANNERSTILL PURNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1655 W MEQUON RD, MEQUON, WI 53092-3254
(414) 266-3339
(262) 240-9745
Mailing address
9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6895-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760598221
—
WI
05
—
40964300
—
WI
Enumeration date
08/21/2006
Last updated
01/18/2022
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