Individual
DR. JESSICA ANN DEPETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO, MSC
Contact information
Practice address
26091 BEAUMONT BLVD., D3-1708, SOUTHFIELD, MI 48033
(947) 522-3088
Mailing address
26091 BEAUMONT BLVD., D3-1708, SOUTHFIELD, MI 48033
(947) 522-3088
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5151014796APP21
MI
Other
Enumeration date
06/11/2021
Last updated
06/11/2021
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