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General NPI Number Information
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NPI Number | 1013685726
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Entity Type | Individual
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Provider Name | JEMMA NICOLE AL'SALAAM QMHP
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Gender | Female
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 201 E 5TH ST STE 1900
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City | CINCINNATI
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State | OH
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Zip | 45202-4162
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Country | US
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Telephone | 513-766-9418
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Fax |
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Provider Business Mailing Address
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Address Line | 1533 ELLIS RD APT K205
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City | DURHAM
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State | NC
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Zip | 27703-6408
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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