Provider Demographics
NPI:1740743863
Name:OPP, JAMI SUE (CDCA, MSCJ)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:SUE
Last Name:OPP
Suffix:
Gender:F
Credentials:CDCA, MSCJ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 BROOKWOOD PARK
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-3303
Mailing Address - Country:US
Mailing Address - Phone:419-208-3330
Mailing Address - Fax:
Practice Address - Street 1:65 SAINT FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-3413
Practice Address - Country:US
Practice Address - Phone:567-220-7018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH162126101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)