Individual
JESSICA NOEL GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
542 ROUTE 6 AND 209, MILFORD, PA 18337-9449
(570) 296-1054
(570) 296-9227
Mailing address
PO BOX 1195, MILFORD, PA 18337-2195
(570) 296-1054
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
11/19/2008
Last updated
11/19/2008
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