Individual
MRS. JENNIFER MICHELE PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2613 FAIRWAY DR, FULTON, MO 65251-4030
(573) 642-1990
(573) 642-5089
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2000166715
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
495176026
—
MO
Enumeration date
08/29/2005
Last updated
11/10/2022
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