Individual
MS. JESSICA MARIE BURGOS BLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3211 GLOVER DR, ASHTABULA, OH 44004-8963
(440) 645-2906
Mailing address
3211 GLOVER DR, ASHTABULA, OH 44004-8963
(440) 645-2906
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.192522
OH
175T00000X
Peer Specialist
Primary
APS.006098
OH
Other
Enumeration date
03/05/2025
Last updated
07/15/2025
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