MEDICARE: JESSICA WOODWARD QUICK MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	116131	MA

General Provider Information

NPI Number	:	1427395235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA WOODWARD QUICK MSW

Provider Business Mailing Address
First Line	:	1939 W 32ND AVE APT 104
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-3444
Country	:	US
Telephone Number	:	315-725-8687
Fax Number	:

Provider Business Practice Location Address
First Line	:	1939 W 32ND AVE APT 104
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-3444
Country	:	US
Telephone Number	:	315-725-8687
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2013
Last Update Date	:	01/14/2013

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