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Individual

JUSTIN JEREMY BISHOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1200 N WEST AVE, JACKSON, MI 49202-2179
(517) 780-3350
(517) 789-1286
Mailing address
9483 GALATIAN DR, WHITMORE LAKE, MI 48189-9716
(734) 646-8426

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802090398
MI
1041C0700X
Clinical Social Worker
6802090398
MI

Other

Enumeration date
07/15/2019
Last updated
07/15/2019
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