Individual
JESSICA DE GROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CT
Contact information
Practice address
2211 ARBOR BLVD, MORAINE, OH 45439-1521
(937) 222-9481
Mailing address
16 GEBHART ST, DAYTON, OH 45410-1719
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.2405426-TRNE
OH
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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