Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YS0200X | School Counselor | ||
Y | 104100000X | Social Worker | 0009922611 | CO |
N | 1041C0700X | Clinical Social Worker |
NPI | 1053918326 |
---|---|
Provider Name | Jenna Ranae Kapp |
First Address | Wheat Ridge, CO 80033-6712 |
Second Address | Wheat Ridge, CO 80033-6712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2020 |
Last Update Date | 08/10/2020 |