Individual
JENNIFER C LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
6410 NE HALSEY ST, STE 300, PORTLAND, OR 97213-4742
(503) 215-4691
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4794
OR
Other
Enumeration date
01/03/2012
Last updated
04/25/2012
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