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Individual

MRS. JEANETTE INEZ PYCRAFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
246 NORTHLAND DR STE 200A, MEDINA, OH 44256-3440
(330) 725-9195
(330) 725-9187
Mailing address
329 FINDLEY AVE, WELLINGTON, OH 44090-9318
(440) 371-1572

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
I.1700435
OH
1041C0700X
Clinical Social Worker
Primary
I.1700435

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0238729
OH
Enumeration date
08/02/2017
Last updated
02/25/2020
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