Individual
JAY MICHAEL MADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
5340 HOLIDAY TER STE 13, KALAMAZOO, MI 49009-2181
(269) 372-4140
Mailing address
5340 HOLIDAY TER STE 13, KALAMAZOO, MI 49009-2181
(269) 372-4140
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401223782
MI
Other
Enumeration date
07/19/2021
Last updated
10/12/2023
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