Individual
ANNETTE LYNN MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
805 SUPERIOR ST, PORT HURON, MI 48060-3771
(810) 966-1972
Mailing address
4079 JANICE AVE, FORT GRATIOT, MI 48059-3771
(810) 333-3429
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401013836
MI
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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