Individual
JESSE MICHAEL NUSSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
1750 NEBRASKA AVE BLDG B, GRANTS PASS, OR 97527-5700
(541) 476-3302
Mailing address
715 SW RAMSEY AVE, GRANTS PASS, OR 97527-5500
(541) 956-4943
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
03/25/2012
Last updated
03/24/2018
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