Individual
JESSICA TIETJE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4334 SECOR RD, TOLEDO, OH 43623-4234
(419) 517-1758
Mailing address
2055 NAPOLEON RD, APT 21-O, BOWLING GREEN, OH 43402-9151
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/17/2015
Last updated
11/01/2018
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