Individual
JILLANE MOFFITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4200 W MICHIGAN AVE, KALAMAZOO, MI 49006-5892
(269) 370-3038
Mailing address
2310 HAZEL AVE, KALAMAZOO, MI 49008-2743
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801092498
MI
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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