Provider Demographics
NPI:1932721537
Name:CALLIGAN, JESSICA HUNG (SWT)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:HUNG
Last Name:CALLIGAN
Suffix:
Gender:F
Credentials:SWT
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:MARCIA
Other - Last Name:HUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SWT
Mailing Address - Street 1:2211 ARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1521
Mailing Address - Country:US
Mailing Address - Phone:937-222-9481
Mailing Address - Fax:937-222-3710
Practice Address - Street 1:2211 ARBOR BLVD
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-1521
Practice Address - Country:US
Practice Address - Phone:937-222-9481
Practice Address - Fax:937-222-3710
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1700063-TRNE1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical