Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 8973 | KS |
NPI | 1003238429 |
---|---|
Provider Name | Vanessa S. Jones |
First Address | Manhattan, KS 66505-0747 |
Second Address | Junction City, KS 66441-5210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2014 |
Last Update Date | 21/01/2014 |