Individual
MR. CHARLES JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
6130 COCHISE DR, WEST BLOOMFIELD, MI 48322-2361
(248) 752-5080
(248) 254-1736
Mailing address
6130 COCHISE DR, WEST BLOOMFIELD, MI 48322-2361
(248) 752-5080
(248) 254-1736
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401003373
MI
Other
Enumeration date
02/07/2011
Last updated
02/07/2011
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