Individual
JENNIFER MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.L.P.C.
Contact information
Practice address
5659 CARDWELL ST, GARDEN CITY, MI 48135-2902
(313) 463-9441
Mailing address
5659 CARDWELL ST, GARDEN CITY, MI 48135-2902
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401015621
MI
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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