Individual
JODI R KLUBNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11530 US 49 SUITE E, GULFPORT, MS 39503-3950
(228) 707-2007
Mailing address
4509 JEFFERSON AVE, GULFPORT, MS 39507-4022
(228) 707-2007
(228) 707-4119
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M9094
MS
1041C0700X
Clinical Social Worker
Primary
C9094
MS
Other
Enumeration date
12/07/2015
Last updated
02/25/2025
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