Individual
JESSICA NEVILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 E NATIONAL AVE, BRAZIL, IN 47834-2717
(812) 448-8801
Mailing address
PO BOX 4323, TERRE HAUTE, IN 47804-0323
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002586A
IN
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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