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Individual

JILL ALANE POPPE MACKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
JD, LSW

Contact information

Practice address
955 CONGRESS PARK DR, CENTERVILLE, OH 45459-4009
(937) 269-3047
Mailing address
628 LOXWOOD LN, DAYTON, OH 45458-6301
(952) 240-6060

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
S1451150
OH
104100000X
Social Worker
S1451150
OH
1041C0700X
Clinical Social Worker
Primary
S1451150
OH

Other

Enumeration date
11/06/2017
Last updated
10/10/2024
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