Individual
AMANDA JESKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1070 W HOUGHTON LAKE DR, PRUDENVILLE, MI 48651-9613
(989) 272-3073
Mailing address
1070 W HOUGHTON LAKE DR, PRUDENVILLE, MI 48651-9613
(989) 272-3073
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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