Individual
JENNIFER MICKEY-TELLEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 293-8300
Mailing address
5460 DOVETREE BLVD APT 21, MORAINE, OH 45439-2170
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.2613400
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/12/2025
Last updated
01/26/2026
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