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Individual

JENNIFER J JOHANTGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3151 COUNTY ROAD 2425, STRYKER, OH 43557-9418
(419) 428-3650
Mailing address
3151 COUNTY ROAD 2425, STRYKER, OH 43557-9418

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S1302232
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
S1302232
LICENSE
OH
Enumeration date
10/07/2017
Last updated
10/07/2017
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