Provider Demographics
NPI:1760916506
Name:WOJCIECHOWSKI, JENNIFER LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:WOJCIECHOWSKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:SEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:620 FOX ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446
Mailing Address - Country:US
Mailing Address - Phone:810-660-8275
Mailing Address - Fax:810-660-8142
Practice Address - Street 1:620 FOX ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446
Practice Address - Country:US
Practice Address - Phone:810-660-8275
Practice Address - Fax:810-660-8142
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010793071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical