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Individual

JESSICA MICHAEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
399 E MAIN ST, COLUMBUS, OH 43215-5384
(614) 355-8550
(614) 355-8593
Mailing address
DEPT 781625, DETROIT, MI 48278-1625
(614) 355-8004
(614) 355-2200

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I1451292
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2846675
OH
Enumeration date
04/10/2015
Last updated
04/10/2015
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