Individual
MR. JERRY NEWPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
474 N. YELLOW SPRINGS ST, MENTAL HEALTH SERVICES FOR CLARK AND MADISON COUNTIES, SPRINGFIELD, OH 45504
(937) 399-9500
(937) 342-4242
Mailing address
474 N. YELLOW SPRINGS, MENTAL HEALTH SERVICES FOR CLARK AND MADISON COUNTIES, SPRINGFIELD, OH 45504
(937) 399-9500
(937) 342-4242
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E-0001738-SUPV
OH
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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