Provider Demographics
NPI:1942561345
Name:KLINGLER, JENNIFER ETCHISON (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ETCHISON
Last Name:KLINGLER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 WYNDHURST AVE
Mailing Address - Street 2:SUITE 245E
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2489
Mailing Address - Country:US
Mailing Address - Phone:443-682-7780
Mailing Address - Fax:443-682-7781
Practice Address - Street 1:600 WYNDHURST AVE
Practice Address - Street 2:SUITE 245E
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2489
Practice Address - Country:US
Practice Address - Phone:443-682-7780
Practice Address - Fax:443-682-7781
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD121851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical