Individual
MS. CONNI JANI LUTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
8036 MOORSBRIDGE ROAD, SUITE #2, PORTAGE, MI 49024-4417
(269) 327-1438
(269) 327-6454
Mailing address
PO BOX 2585, PORTAGE, MI 49081-2585
(269) 381-0150
(269) 373-4720
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
W 6801046168
MI
Other
Enumeration date
09/08/2006
Last updated
07/08/2007
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