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Organization

DOT TETREAULT, LMSW, ACSW PLLC

Active
Parent organization
DOT TETREAULT, LMSW, ACSW PLLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
DOT TETREAULT, LMSW, ACSW PLLC
Authorized official
DORORTHY E TETREAULT LMSW, ACSW (OWNER)
(517) 787-8170
Entity
Organization

Contact information

Practice address
569 WILDWOOD AVE, JACKSON, MI 49201-1048
(517) 787-8170
(517) 787-8170
Mailing address
569 WILDWOOD AVE, JACKSON, MI 49201-1048
(517) 787-8170
(517) 787-8170

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6801081579
MI

Other

Enumeration date
10/08/2011
Last updated
07/23/2014
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