Doctor Name: | RICHARD JASTRZEBSKI |
NPI Number: | 1124497490 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 120 W Exchange St Ste 300 Owosso, MI - 488672834 |
Business Phone Number: | 9897238239 |
Business Fax Number: | |
Mailing Address: | 507 S Cedar St, OWOSSO |
State: | MI |
Postal Code: | 488673403 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/17/2015 |
NPI Last Update Date: | 09/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |