Individual
MARY JO ANN WALENTOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 S PARKER ST, MARINE CITY, MI 48039-3579
(810) 887-2805
Mailing address
310 S PARKER ST, P.O. BOX 514, MARINE CITY, MI 48039-3579
(810) 887-2805
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401012278
MI
Other
Enumeration date
09/26/2011
Last updated
10/27/2011
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