Individual
JESSICA J MAYVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2517 N VIEW CT, GREEN BAY, WI 54303-6233
(920) 494-5454
Mailing address
2690 HUMBOLDT RD APT 7, GREEN BAY, WI 54311-8403
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/31/2021
Last updated
03/31/2021
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