Individual
JENNIFER MARIE BAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LMFT
Contact information
Practice address
1208 ENGLEWOOD AVE, ROYAL OAK, MI 48073-2835
(248) 462-3627
Mailing address
1208 ENGLEWOOD AVE, ROYAL OAK, MI 48073-2835
(248) 462-3627
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
L2128396
MI
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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