Individual
JESSICA M ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
419 LINDEN ST, CADILLAC, MI 49601-1703
(231) 510-2391
Mailing address
419 LINDEN ST, CADILLAC, MI 49601-1703
(231) 510-2391
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5202007371
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U1909984804
CIGNA
—
Enumeration date
04/04/2011
Last updated
04/04/2011
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