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General NPI Number Information
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NPI Number | 1861913659
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Entity Type | Individual
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Provider Name | JANELLE JEFFREY LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 06/30/2017
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Provider Practice Location Address
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Address Line | 1013 W 8TH ST STE A
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City | JUNCTION CITY
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State | KS
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Zip | 66441-2281
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Country | US
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Telephone | 785-210-9619
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Fax |
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Provider Business Mailing Address
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Address Line | 113 COMMANCHE CT
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City | JUNCTION CITY
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State | KS
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Zip | 66441-9777
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Country | US
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Telephone | 785-210-9619
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 10466
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License Number State | KS
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