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Individual

JESSICA R VITALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10441 GLEN LEE TRL, GRANGER, IN 46530-9436
(574) 339-9432
Mailing address
10441 GLEN LEE TRL, GRANGER, IN 46530-9436
(574) 339-9432

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149.029417
IL
1041C0700X
Clinical Social Worker
Primary
34012033A
IN

Other

Enumeration date
06/12/2025
Last updated
06/12/2025
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