Individual
MR. JASON FREDRICK HEUSTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 S MAIN ST, SUITE C, MILFORD, MI 48381-1975
(248) 390-5791
Mailing address
13469 BRYSON CT, FENTON, MI 48430-1078
(248) 762-3340
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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