Individual provider · Type 1 NPI

Jacquelyn Clemons, LLBSW

Student in an Organized Health Care Education/Training Program · Ecorse, MI

NPI number 1417476151 Active

Practice location

4300 6th St
Ecorse, MI 48229-1110

Mailing address

9348 Tobine St
Romulus, MI 48174-3365

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

About NPI 1417476151

Jacquelyn Clemons, LLBSW's National Provider Identifier is 1417476151, issued on Sep 13, 2017. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Ecorse, MI. The record was last updated on Sep 13, 2017.