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Individual

MR. JASON E BANIUKAITIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, TLLP

Contact information

Practice address
7195 THORNAPPLE RIVER DR SE STE C, ADA, MI 49301-8411
(616) 929-0248
Mailing address
4165 REX VALLEY DR NE, ROCKFORD, MI 49341-8511
(616) 826-3045

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6362010197
MI

Other

Enumeration date
08/27/2025
Last updated
08/27/2025
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