Individual
JESSICA AILSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
5360 HOLIDAY TER STE 18, KALAMAZOO, MI 49009-2126
(269) 447-1211
Mailing address
5360 HOLIDAY TER STE 18, KALAMAZOO, MI 49009-2126
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
MI
101YM0800X
Mental Health Counselor
—
MI
101YP2500X
Professional Counselor
—
MI
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
03/15/2018
Last updated
01/23/2024
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