MEDICARE: MS. JENNIFER ANNE LIERZ 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	005214	MO

General Provider Information

NPI Number	:	1972542199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER ANNE LIERZ MSW

Provider Business Mailing Address
First Line	:	3737 SOUTH ELIZABETH AVE.
Second Line	:	SUITE 100
City	:	INDEPENDENCE
State	:	MO
Zip	:	64057
Country	:	US
Telephone Number	:	816-373-7577
Fax Number	:	816-373-9572

Provider Business Practice Location Address
First Line	:	3737 SOUTH ELIZABETH AVE.
Second Line	:	SUITE 100
City	:	INDEPENDENCE
State	:	MO
Zip	:	64057
Country	:	US
Telephone Number	:	816-373-7577
Fax Number	:	816-373-9572

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	07/09/2007

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