Individual
MISS JASMINE RANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
915 AIRPORT RD, JACKSON, MI 49202-1872
(517) 499-2976
Mailing address
PO BOX 10, MASON, MI 48854-0010
(517) 676-9788
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801106362
MI
1041C0700X
Clinical Social Worker
6801100971
MI
Other
Enumeration date
07/10/2018
Last updated
11/20/2020
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