Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 130926-121 | WI |
NPI | 1003315219 |
---|---|
Provider Name | Ms. Jasmine G Window |
First Address | Racine, WI 53406-5338 |
Second Address | Milwaukee, WI 53210-1617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2018 |
Last Update Date | 03/02/2018 |