Individual
JESSICA MARIE LIVERNOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
649 WOODSEDGE LN, WHITE LAKE, MI 48386-3554
(248) 255-5285
Mailing address
649 WOODSEDGE LN, WHITE LAKE, MI 48386-3554
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
L165403585699
MI
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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