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Individual

JEFFREY BLOSSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
2426 E PIERCETON RD, WINONA LAKE, IN 46590-5713
(574) 269-7990
Mailing address
312 1/2 S. 5TH STREET, APARTMENT B, GOSHEN, IN 46528
(574) 329-3984

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
02/11/2015
Last updated
02/11/2015
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