Individual provider · Type 1 NPI
Jessica Lynn Deatherage, MC TRAINEE
Professional Counselor · Auburn, CA
NPI number
1245046168
Active
Practice location
1275 High St
Auburn, CA 95603-5016
Mailing address
8740 Gilardi Rd
Newcastle, CA 95658-9341
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | None listed |
Professional Counselor: Definition to come...
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About NPI 1245046168
Jessica Lynn Deatherage, MC TRAINEE's National Provider Identifier is 1245046168, issued on Dec 5, 2024. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Auburn, CA. The record was last updated on Dec 5, 2024.