Individual
BARRY JENNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1365 SHOMAN ST, WATERFORD, MI 48327-1862
(248) 461-6050
Mailing address
1365 SHOMAN ST, WATERFORD, MI 48327-1862
(248) 461-6050
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6801087561
MI
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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