| Jennifer Deja Msw Plc | |
|
130 W Wood St Newaygo MI 49337-8991 | |
| (231) 206-6159 | |
| Not Available |
| Full Name | Jennifer Deja Msw Plc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 130 W Wood St, Newaygo, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Deja Msw Plc Po Box 10 Mason MI 48854-0010 Ph: () - | Jennifer Deja Msw Plc 130 W Wood St Newaygo MI 49337-8991 Ph: (231) 206-6159 |
| NPI Number | 1992221345 |
|---|---|
| Provider Enumeration Date | 08/17/2017 |
| Last Update Date | 07/21/2022 |
| Certification Date | 01/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992221345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (Michigan) | Primary |
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