Individual
JEANINE MARIE HARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADAC II
Contact information
Practice address
2068 LUCAS PKWY, LOWELL, IN 46356-2169
(219) 690-7025
(219) 696-1550
Mailing address
2068 LUCAS PKWY, LOWELL, IN 46356-2169
(219) 690-7025
(219) 696-1550
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CII-2063
IN
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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