Individual
HEIDI JAECKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
4081 CASCADE RD SE STE 100, GRAND RAPIDS, MI 49546-2170
(616) 319-1978
Mailing address
6118 MONTMORENCY DR SE, CALEDONIA, MI 49316-8059
(518) 669-6034
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6451020894
MI
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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