Doctor Name: | JENNIFER R JACKSON-COLBURN |
NPI Number: | 1497787154 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSCSW |
License Number: | LSCSW 3733 |
Business Practice Address: | 25955 W 327th St Paola, KS - 660714920 |
Business Phone Number: | 9135579096 |
Business Fax Number: | 9132949247 |
Mailing Address: | Po Box 677, OTTAWA |
State: | KS |
Postal Code: | 660670677 |
Phone Number: | 9135579096 |
Fax Number: | 9132949247 |
NPI Enumeration Date: | 07/06/2006 |
NPI Last Update Date: | 02/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LSCSW 3733 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |