Individual
JASON VANLESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A,
Contact information
Practice address
232 E MICHIGAN AVE, PAW PAW, MI 49079-1409
(269) 870-6919
Mailing address
PO BOX 26, PAW PAW, MI 49079-0026
(269) 870-6919
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/21/2009
Last updated
09/01/2010
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