Individual
MS. JACLYN JORGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2349
(231) 935-6210
Mailing address
2513 MOMENTUM PL, CHICAGO, IL 60689-5325
(231) 935-6210
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401011728
MI
Other
Enumeration date
06/03/2015
Last updated
04/20/2016
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