Doctor Name: | MRS. JEAN MARY AINSWORTH |
NPI Number: | 1174853816 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 22015 |
Business Practice Address: | 14712 Old Westside Rd Grenada, CA - 96038 |
Business Phone Number: | 5304369860 |
Business Fax Number: | |
Mailing Address: | P.o. Box 218, GRENADA |
State: | CA |
Postal Code: | 960380218 |
Phone Number: | 5304369860 |
Fax Number: | |
NPI Enumeration Date: | 12/31/2009 |
NPI Last Update Date: | 03/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 22015 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |