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Individual

MS. JENNIFER LYNN IMBAULT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LLPC

Contact information

Practice address
200 HOLTON RD, UNIT D, MUSKEGON, MI 49445-3349
(231) 744-5100
(231) 744-5100
Mailing address
PO BOX 304, WHITEHALL, MI 49461-0304
(231) 730-4330

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401010258
MI

Other

Enumeration date
04/16/2007
Last updated
07/08/2007
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