Individual
SAM JAZAYERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3640 N BRIARWOOD LN, MUNCIE, IN 47304-6375
(637) 777-5098
Mailing address
3640 N BRIARWOOD LN, MUNCIE, IN 47304-6375
(574) 229-1690
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/15/2022
Last updated
07/15/2022
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