Individual
JESSICA GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 34, MAYVILLE, MI 48744-0034
(989) 372-0271
Mailing address
PO BOX 34, MAYVILLE, MI 48744-0034
(989) 372-0271
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
6801114892
MI
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
03/16/2020
Last updated
03/27/2025
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