Provider Demographics
NPI:1366872921
Name:INFANGER, JENNY
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:INFANGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 988
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51502-0988
Mailing Address - Country:US
Mailing Address - Phone:712-352-2223
Mailing Address - Fax:
Practice Address - Street 1:10874 S REDBUD LN
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5778
Practice Address - Country:US
Practice Address - Phone:801-318-6084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6246475-35021041C0700X
IA0906931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical