Individual
ANTANIQUE JENNIRA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
30101 HOOVER RD, WARREN, MI 48093-6572
(586) 558-6868
Mailing address
18964 PLAINVIEW AVE, DETROIT, MI 48219-2851
(313) 978-7999
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/12/2021
Last updated
06/28/2024
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