Provider Demographics
NPI:1376105908
Name:WOZNIAK, JENNIFER (LSWAIC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WOZNIAK
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7827 MERO RD
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-7341
Mailing Address - Country:US
Mailing Address - Phone:630-202-8630
Mailing Address - Fax:
Practice Address - Street 1:7827 MERO RD
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-7341
Practice Address - Country:US
Practice Address - Phone:630-202-8630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-03
Last Update Date:2022-03-15
Deactivation Date:2022-02-28
Deactivation Code:
Reactivation Date:2022-03-15
Provider Licenses
StateLicense IDTaxonomies
WA60941152104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker