| Jill L. Jividen | |
|
112 E Main St Fl 2 Kent OH 44240-2525 | |
| (330) 414-5652 | |
| Not Available |
| Full Name | Jill L. Jividen |
|---|---|
| Speciality | Counselor - Professional |
| Location | 112 E Main St Fl 2, Kent, Ohio |
| Authorized Official Name and Position | Jill Jividen (OWNER) |
| Authorized Official Contact | 3304145652 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jill L. Jividen 853 Stonewater Dr Kent OH 44240-2052 Ph: () - | Jill L. Jividen 112 E Main St Fl 2 Kent OH 44240-2525 Ph: (330) 414-5652 |
| NPI Number | 1023706454 |
|---|---|
| Provider Enumeration Date | 04/25/2023 |
| Last Update Date | 04/25/2023 |
| Certification Date | 04/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023706454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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