Individual
MRS. JEANETTE ELAINE OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Contact information
Practice address
3525 ELIZABETH LAKE RD, WATERFORD, MI 48328-3087
(248) 249-5453
Mailing address
3016 HAVENWOOD DR, WHITE LAKE, MI 48383-3903
(248) 249-5453
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
L2083707
MI
101YM0800X
Mental Health Counselor
L2083707
MI
101YP2500X
Professional Counselor
Primary
L2083707
MI
103K00000X
Behavior Analyst
L2083707
MI
Other
Enumeration date
09/03/2012
Last updated
01/16/2014
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