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Jennifer Marie Davis, LMSW

Social Worker in Deer Park, NY. Individual provider (NPI-1).

NPI number1962045369
StatusActive
Last updated in NPPESOct 18, 2019

Details

NPI
1962045369
Entity type
Individual (NPI-1)
Name
Jennifer Marie Davis
Credential
LMSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 18, 2019
Last updated
Oct 18, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
104100000X Social Worker098380NYYes

Practice location

770 Grand Blvd
Deer Park, NY 11729-5750

Phone 631-392-4357

Mailing address

5 Pearl Ct
West Islip, NY 11795-2222

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