Provider Demographics
NPI:1083311120
Name:VELEZ, JESSICA (CASE AIDE ASSISTANT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:VELEZ
Suffix:
Gender:F
Credentials:CASE AIDE ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CANARY HILL DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48359-1812
Mailing Address - Country:US
Mailing Address - Phone:586-625-9959
Mailing Address - Fax:
Practice Address - Street 1:1841 N PERRY ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48340-2235
Practice Address - Country:US
Practice Address - Phone:248-409-4113
Practice Address - Fax:248-994-8005
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator