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1083170963
JESSICA AMBER BAZAN DERAEDT
JACKSON, MI
NPI
1083170963
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6801101750)
Enumeration Date
2019-02-15
Last Update Date
2020-07-17
Business Address
Mrs. JESSICA AMBER BAZAN DERAEDT LMSW
1108 HOMEWILD AVE
JACKSON, MI 49201-1835
Phone number: 231-679-0648
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Mailing Address
Mrs. JESSICA AMBER BAZAN DERAEDT LMSW
1108 HOMEWILD AVE
JACKSON, MI 49201-1835
Phone number: 231-679-0648
Copy
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