Doctor Name: | MS. JENNIFER JO FAUL |
NPI Number: | 1043385032 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW IN ND LGSW IN M |
License Number: | 2994 |
Business Practice Address: | 2925 20th St S Moorhead, MN - 56560 |
Business Phone Number: | 2182840300 |
Business Fax Number: | 2182845944 |
Mailing Address: | Po Box 111, DAVENPORT |
State: | ND |
Postal Code: | 58021 |
Phone Number: | 7013716550 |
Fax Number: | |
NPI Enumeration Date: | 11/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2994 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ND |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |