Individual
CASSIDY LYNN JEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
890 N 10TH ST STE 110, KALAMAZOO, MI 49009-6192
(888) 527-0012
Mailing address
22313 SOLOMON BLVD APT 208, NOVI, MI 48375-5081
(859) 404-3064
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6851115878
MI
1041C0700X
Clinical Social Worker
6851115878
MI
172V00000X
Community Health Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
07/31/2018
Last updated
11/14/2023
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