Individual
MARY JANE MADSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.P.C.
Contact information
Practice address
2300 GENOA BUSINESS PARK DR, SUITE 106, BRIGHTON, MI 48114-7367
(810) 623-4631
(810) 229-5337
Mailing address
779 WESTBROOKE DR, SOUTH LYON, MI 48178-1665
(248) 486-8487
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401009263
MI
Other
Enumeration date
11/17/2008
Last updated
12/15/2010
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