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JESSICA JAYNE STORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
12165 STATE HIGHWAY 14 N STE B7, CEDAR CREST, NM 87008-9538
(505) 913-7771
Mailing address
78 POMEROY TER, NORTHAMPTON, MA 01060-3378
(413) 585-1310
(413) 586-1490

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
X-11338
NM

Other

Enumeration date
10/09/2013
Last updated
12/04/2019
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