Individual
JAN MICHELE VAN CHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2059 E PASS RD STE 4, GULFPORT, MS 39507-3761
(228) 314-3626
Mailing address
15520 DANIEL BLVD STE E, GULFPORT, MS 39503-4744
(228) 314-3626
(228) 314-3141
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
13093
LA
1041C0700X
Clinical Social Worker
Primary
C8228
MS
1041C0700X
Clinical Social Worker
SW 9156
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08856031
—
MS
Enumeration date
09/29/2015
Last updated
02/22/2022
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