Doctor Name: | JENNIFER ASHLEY RICH |
NPI Number: | 1023478138 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LCSW |
License Number: | SW 12824 |
Business Practice Address: | 207 Marshall Dr Perry, FL - 323471835 |
Business Phone Number: | 3866883151 |
Business Fax Number: | |
Mailing Address: | 21995 148th St, LIVE OAK |
State: | FL |
Postal Code: | 320605318 |
Phone Number: | 3866883151 |
Fax Number: | |
NPI Enumeration Date: | 03/02/2016 |
NPI Last Update Date: | 03/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SW 12824 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |