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Individual
JESSICA GATES
Active
Individual
JESSICA GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801102276
MI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/23/2018
Last updated
12/18/2018
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