Individual
JESSICA LYNN STIVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
700 E NORWEGIAN ST, POTTSVILLE, PA 17901-2710
(570) 621-4000
Mailing address
131 DELL ST, EMMAUS, PA 18049-3109
(484) 894-7165
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MA061381
PA
Other
Enumeration date
01/12/2020
Last updated
01/12/2020
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