Individual
MRS. JENNIFER NICHOLE SUSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Contact information
Practice address
1080 KIRTS BLVD STE 100, TROY, MI 48084-4853
(586) 744-9902
Mailing address
16212 TIMBERVIEW DR, CLINTON TWP, MI 48036-1655
(586) 744-9902
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
MI
Other
Enumeration date
09/02/2020
Last updated
09/17/2020
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