Individual
JACQUELYN BUFFO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15420 19 MILE RD, CLINTON TOWNSHIP, MI 48038-6339
(586) 226-7007
Mailing address
3079 S BALDWIN RD # 3020, LAKE ORION, MI 48359-1028
(586) 464-7432
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6401013525
MI
101YP2500X
Professional Counselor
Primary
6401013525
MI
Other
Enumeration date
06/23/2014
Last updated
10/09/2024
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