Provider Demographics
NPI:1013033307
Name:GARLAND, JENNIFER KATHLEEN (PLCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KATHLEEN
Last Name:GARLAND
Suffix:
Gender:F
Credentials:PLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MARBLE HILL
Mailing Address - State:MO
Mailing Address - Zip Code:63764-8351
Mailing Address - Country:US
Mailing Address - Phone:573-238-5240
Mailing Address - Fax:573-238-3318
Practice Address - Street 1:3191 OLD CAPE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-3725
Practice Address - Country:US
Practice Address - Phone:573-204-8901
Practice Address - Fax:573-204-8902
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070072181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical