Individual
JESSICA FRANCES DEROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLBSW
Contact information
Practice address
715 PYLE DR, KINGSFORD, MI 49802-4456
(906) 239-9253
(906) 779-0645
Mailing address
715 PYLE DR, KINGSFORD, MI 49802-4456
(906) 239-9253
(906) 779-0645
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802091292
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6852091292
—
MI
Enumeration date
03/14/2022
Last updated
09/28/2022
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