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NPI Code Detail

MEDICARE: MISS JENNIFER L. CLYMER MA, PCC

MEDICARE: MISS JENNIFER L. CLYMER MA, PCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorE.0700093OH

General Provider Information

NPI Number : 1356584221
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNIFER L. CLYMER MA, PCC
Provider Business Mailing Address
First Line : PO BOX 8970
Second Line :
City : TOLEDO
State : OH
Zip : 43623-0970
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 123 22ND ST
Second Line :
City : TOLEDO
State : OH
Zip : 43604-2706
Country : US
Telephone Number : 419-241-6191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2009
Last Update Date : 08/07/2012

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