Individual
JASON ITRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLMSW
Contact information
Practice address
35455 GARFIELD RD, CLINTON TWP, MI 48035-2236
(586) 792-5335
Mailing address
805 BROWN ST, MARINE CITY, MI 48039-1742
(810) 580-0543
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801104527
MI
Other
Enumeration date
06/13/2019
Last updated
06/20/2019
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