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Jerrry Indra, PRC
Peer Specialist in Flint, Michigan
NPI 1003512955

Jerrry Indra is a Peer Specialist based in Flint, MI. Jerrry Indra practices in Flint, MI and has the professional credentials of PRC. The NPI Number for Jerrry Indra is 1003512955 and holds a License No. (Michigan).

The current practice location address for Jerrry Indra is 765 E Hamilton Ave, Flint, MI and can be reached out via phone at 810-233-5340.

Location: 765 E Hamilton Ave, Flint, MI, 48505-4707
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003512955
Provider Name
Jerrry Indra
Credential
PRC
Provider Entity Type
Individual
Gender
Male
Address
765 E Hamilton Ave, Flint, MI, 48505-4707
Phone Number
810-233-5340
Fax Number
Provider Enumeration Date
02/02/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
765 E Hamilton Ave
City
Flint
State
Michigan
Zip
48505-4707
Phone Number
810-233-5340
Fax Number
person
Provider Business Mailing Address Details
Address
765 E Hamilton Ave
City
Flint
State
Michigan
Zip
48505-4707
Phone Number
810-233-5340
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Michigan)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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