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Organization
JACK PINE WELLNESS, PLLC
Active
Organization
JACK PINE WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTA RANSOM-SOPER LCSW LMSW (OWNER)
(989) 523-0002
Entity
Organization
Contact information
Practice address
138 HARTSHORN ST, BAD AXE, MI 48413-1358
(989) 523-0002
Mailing address
138 HARTSHORN ST, BAD AXE, MI 48413-1358
(989) 523-0002
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/19/2024
Last updated
06/17/2024
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