Organization
MESA WAA GII, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE SELBY LCSW (OWNER/OPERATOR)
(765) 231-5672
Entity
Organization
Contact information
Practice address
115 N GREEN ST STE 102, CRAWFORDSVILLE, IN 47933-1708
(765) 366-2644
Mailing address
115 N GREEN ST STE 102, CRAWFORDSVILLE, IN 47933-1708
(765) 366-2644
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/10/2024
Last updated
03/04/2024
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