Provider Demographics
NPI:1659961332
Name:NABOZNY, JESSICA (LSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:NABOZNY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 319
Mailing Address - Street 2:
Mailing Address - City:BIGLER
Mailing Address - State:PA
Mailing Address - Zip Code:16825-0319
Mailing Address - Country:US
Mailing Address - Phone:814-342-5678
Mailing Address - Fax:814-342-2755
Practice Address - Street 1:620 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-1722
Practice Address - Country:US
Practice Address - Phone:814-643-0309
Practice Address - Fax:814-643-5502
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW134795104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker