| Jennifer Patrick, Lcsw, Limited | |
|
2625 Fairway Dr Ste. A Fulton MO 65251-4023 | |
| (573) 642-2102 | |
| Not Available |
| Full Name | Jennifer Patrick, Lcsw, Limited |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2625 Fairway Dr, Fulton, Missouri |
| Authorized Official Name and Position | Jennifer Michele Patrick (SOLE-PROPRIETOR) |
| Authorized Official Contact | 5736422102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Patrick, Lcsw, Limited 2625 Fairway Dr Ste. A Fulton MO 65251-4023 Ph: (573) 642-2102 | Jennifer Patrick, Lcsw, Limited 2625 Fairway Dr Ste. A Fulton MO 65251-4023 Ph: (573) 642-2102 |
| NPI Number | 1316247265 |
|---|---|
| Provider Enumeration Date | 10/26/2010 |
| Last Update Date | 11/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316247265 | NPI | - | NPPES |
| 1831182427 | Other | MO | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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