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Organization
PBJ CONNECTIONS, INC.
Active
Organization
PBJ CONNECTIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HOLLY E JEDLICKA LISW-S (PROGRAM DIRECTOR/THERAPIST)
(614) 395-1395
Entity
Organization
Contact information
Practice address
9734 JUG ST NW, PATASKALA, OH 43062-9746
(614) 395-1395
(740) 924-2002
Mailing address
9734 JUG ST NW, PATASKALA, OH 43062-8691
(614) 395-1395
(740) 924-2002
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
I.0009210
OH
101YM0800X
Mental Health Counselor
I.1500521
OH
101YP2500X
Professional Counselor
E0003696
OH
1041C0700X
Clinical Social Worker
Primary
I1000061
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2807341
—
OH
Enumeration date
08/04/2010
Last updated
10/15/2016
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