Individual
MRS. JESSICA LYNN BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
102 DAWN LN, WAVERLY, OH 45690-9695
(740) 947-7783
Mailing address
2899 MINGO RD, CHILLICOTHE, OH 45601-8762
(740) 485-2416
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I.2203965
OH
104100000X
Social Worker
S.1502311
OH
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0279524
—
OH
Enumeration date
11/03/2015
Last updated
06/14/2023
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