Individual
JESSICA HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4545 SE INA AVE APT 9, MILWAUKIE, OR 97267-5918
(503) 654-5678
(503) 654-1236
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(901) 581-3813
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/15/2015
Last updated
01/15/2015
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