Doctor Name: | JEANINE D SEWELL |
NPI Number: | 1225162431 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CMSW |
License Number: | 6801004152 |
Business Practice Address: | 1302 Cedar St Hancock, MI - 499301019 |
Business Phone Number: | 9064828375 |
Business Fax Number: | |
Mailing Address: | 1302 Cedar St, HANCOCK |
State: | MI |
Postal Code: | 499301019 |
Phone Number: | 9064828375 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6801004152 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |