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409 S Front St Fremont OH 43420-3072 | |
| (419) 680-0937 | |
| (567) 249-0067 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 409 S Front St, Fremont, Ohio |
| Authorized Official Name and Position | Monica Sue Jay (CLINICAL THERAPIST) |
| Authorized Official Contact | 4196800937 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
112 S Collinwood Blvd Fremont OH 43420-4528 Ph: (419) 680-0937 | 409 S Front St Fremont OH 43420-3072 Ph: (419) 680-0937 |
| NPI Number | 1609529288 |
|---|---|
| Provider Enumeration Date | 02/02/2022 |
| Last Update Date | 02/04/2022 |
| Certification Date | 02/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609529288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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