Individual
MRS. JESSICA RENEE KONKOLESKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
3701 E 13 MILE RD STE B, WARREN, MI 48092-3795
(586) 274-0200
(586) 274-0228
Mailing address
27 4TH ST, MOUNT CLEMENS, MI 48043-2516
(586) 954-1028
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
886323
MI
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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