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1073566998
JERRY HAVENS
MARION, IN
NPI
1073566998
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IN 34001583A)
Enumeration Date
2006-05-19
Last Update Date
2007-07-08
Business Address
-- JERRY HAVENS LCSW
505 N WABASH AVE
MARION, IN 46952-2608
Phone number: 765-662-3971
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Mailing Address
-- JERRY HAVENS LCSW
505 N WABASH AVE
MARION, IN 46952-2608
Phone number: 765-662-3971
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