Individual
JESSICA ROSE PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12130 FILLMORE ST, WEST OLIVE, MI 49460-8985
(303) 871-4004
Mailing address
12130 FILLMORE ST, WEST OLIVE, MI 49460-8985
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/22/2022
Last updated
08/06/2024
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