Individual
PAUL JANNAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2325 W SHIAWASSEE AVE, SUITE 105, FENTON, MI 48430-1792
(810) 965-8670
(810) 213-0132
Mailing address
2325 W SHIAWASSEE AVE, SUITE 105, FENTON, MI 48430-1792
(810) 629-2500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
L118310
MI
101YM0800X
Mental Health Counselor
L118310
MI
101YP2500X
Professional Counselor
Primary
L118310
MI
106H00000X
Marriage & Family Therapist
L118310
MI
Other
Enumeration date
11/29/2011
Last updated
10/24/2014
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