Individual
JANE ELIZABETH LEIPOLD DIKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1255 N OAKLAND BLVD, WATERFORD, MI 48327-1582
(248) 406-0090
Mailing address
6917 DESMOND RD, WATERFORD, MI 48329-2815
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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