Individual
MRS. JACKIE MARIE PENLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2513 S EVANSTON AVE, INDEPENDENCE, MO 64052-1564
(816) 836-8499
Mailing address
2513 S EVANSTON AVE, INDEPENDENCE, MO 64052-1564
(816) 836-8499
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2006023224
MO
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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