Individual
JESSICA O'MARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 456-0857
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5101021373
MI
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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