Individual
JASMIN GAYTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
3353 LOUSMA DR SE, WYOMING, MI 49548-2251
(616) 885-8144
Mailing address
3353 LOUSMA DR SE, WYOMING, MI 49548-2251
(616) 885-8144
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164577391
—
MI
Enumeration date
05/16/2019
Last updated
05/16/2019
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