Individual
MRS. JENNIFER JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
702 SUNSET DR, ONTARIO, OR 97914-3121
(541) 889-9167
(541) 889-7873
Mailing address
702 SUNSET DR, ONTARIO, OR 97914-3121
(541) 889-9167
(541) 889-7873
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW-33922
ID
1041C0700X
Clinical Social Worker
Primary
L7594
OR
1041C0700X
Clinical Social Worker
LCSW-37213
ID
Other
Enumeration date
07/18/2014
Last updated
02/12/2020
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