Doctor Name: | MRS. JENNIFER JANET MEDO |
NPI Number: | 1902974660 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 4351 |
Business Practice Address: | 5001 Westbank Expy Marrero, LA - 700722922 |
Business Phone Number: | 5043710255 |
Business Fax Number: | 5043498768 |
Mailing Address: | 5526 Loyola Ave, NEW ORLEANS |
State: | LA |
Postal Code: | 701155013 |
Phone Number: | 5043498755 |
Fax Number: | 5043498768 |
NPI Enumeration Date: | 12/01/2006 |
NPI Last Update Date: | 08/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 4351 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |