Individual
MRS. JENNIFER VANSKYOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCAC
Contact information
Practice address
1758 W 100 S, PORTLAND, IN 47371-8204
(260) 726-1960
Mailing address
1758 W 100 S, PORTLAND, IN 47371-8204
(260) 726-1960
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007406A
IN
Other
Enumeration date
02/08/2016
Last updated
08/04/2016
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