Jennifer Michelle Marram Bognanno, LICSW
Social Worker, Clinical in Brockton, MA. Individual provider (NPI-1).
NPI number1073819082
StatusActive
Last updated in NPPESApr 9, 2018
Details
- NPI
- 1073819082
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Michelle Marram Bognanno
- Credential
- LICSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 8, 2011
- Last updated
- Apr 9, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 216599 | MA | Yes |
| 101YM0800X | Counselor, Mental Health | 216599 | MA |
Practice location
215 Main St Ste 210Brockton, MA 02301-4328
Phone 508-897-8000
Mailing address
Po Box 207Stoughton, MA 02072-0207
Phone 781-801-2809
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