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General NPI Number Information
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NPI Number | 1760559868
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Entity Type | Individual
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Provider Name | JENNIFER MARIE COCKRELL M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2901 RIDGELAKE DR SUITE 104
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City | METAIRIE
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State | LA
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Zip | 70002-4966
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Country | US
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Telephone | 504-723-7583
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Fax |
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Provider Business Mailing Address
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Address Line | 825 DESIRE ST
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City | NEW ORLEANS
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State | LA
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Zip | 70117-6247
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Country | US
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Telephone | 504-947-0579
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4111
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License Number State | LA
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