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Individual

JACLYN SUZANNE GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
110 READING AVE, JONESVILLE, MI 49250-1136
(517) 849-2330
Mailing address
110 READING AVE, JONESVILLE, MI 49250-1136
(517) 849-2330

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
175T00000X
Peer Specialist

Other

Enumeration date
08/03/2020
Last updated
08/03/2020
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  • EDI platform