Provider Demographics
NPI:1760176507
Name:KESSLER, JANE ALEXANDRA (MA)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ALEXANDRA
Last Name:KESSLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10704 LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1533
Mailing Address - Country:US
Mailing Address - Phone:248-875-9539
Mailing Address - Fax:
Practice Address - Street 1:26789 WOODWARD AVE STE 211
Practice Address - Street 2:
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1334
Practice Address - Country:US
Practice Address - Phone:248-398-0866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361002738103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical