Doctor Name: | JAN VICTORIA ANKENBAUER |
NPI Number: | 1144457094 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 3174 |
Business Practice Address: | 1455 S Fort Thomas Ave Fort Thomas, KY - 410752453 |
Business Phone Number: | 8594428439 |
Business Fax Number: | 8597810123 |
Mailing Address: | 1455 S Fort Thomas Ave, FORT THOMAS |
State: | KY |
Postal Code: | 410752453 |
Phone Number: | 8594428439 |
Fax Number: | 8597810123 |
NPI Enumeration Date: | 06/18/2009 |
NPI Last Update Date: | 06/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 3174 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |