Jack Duane Edmondson, LCSW
NPI #1093987166 in Poway, California
Provider Information
- NPI Number
- 1093987166
- Entity Type
- Individual
- Name
- Jack Duane Edmondson, LCSW
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker - Clinical
- Credential
- LCSW
- Enumeration Date
- Mar 29, 2008
- Last Updated
- Mar 29, 2008
Practice Location
- Address
- 14207 KENDRA WAY
- City
- Poway
- State
- California
- ZIP Code
- 92064-3330
- Phone
- (858) 748-7093
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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