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1821382557
JACLYN TISSUE
COLUMBUS, OH
NPI
1821382557
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OH I 1000146)
Enumeration Date
2011-05-28
Last Update Date
2011-05-28
Business Address
-- JACLYN TISSUE LISW
399 E MAIN ST
COLUMBUS, OH 43215-5384
Phone number: 614-355-8550
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Mailing Address
-- JACLYN TISSUE LISW
PO BOX 715194
COLUMBUS, OH 43271-5194
Phone number: 614-355-8004
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