Individual
JESSICA THARA GLIDDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLBSWMI
Contact information
Practice address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 722-5280
Mailing address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 722-5280
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802088650
MI
Other
Enumeration date
10/22/2015
Last updated
10/22/2015
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