Individual
JESSICA BUSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
621 MOUNT VERNON RD, NEWARK, OH 43055-4615
(740) 670-7076
(740) 670-7039
Mailing address
266 TIMBER HEARTH CT, NEWARK, OH 43055-9217
(740) 403-9670
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
20632256
OH
Other
Enumeration date
12/01/2014
Last updated
12/02/2014
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