Individual
JASON M BURSACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 NORTHWEST AVE STE 120, TALLMADGE, OH 44278-1808
(330) 633-4187
Mailing address
5447 HAMPTON PL, SAGINAW, MI 48604-9284
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/01/2021
Last updated
10/31/2023
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