Individual
CARISSA JARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
2136 W M 32, GAYLORD, MI 49735-9282
(989) 732-1791
(989) 732-7052
Mailing address
2136 W M 32, GAYLORD, MI 49735-9282
(989) 732-1791
(989) 732-7052
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164641676
ORGANIZATIONS NPI NUMBER
MI
Enumeration date
06/22/2017
Last updated
06/22/2017
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