Individual
MRS. JENNIFER BUYSSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6749 BUCKHORN ST, PORTAGE, MI 49024-3316
(269) 599-8049
Mailing address
6749 BUCKHORN ST, PORTAGE, MI 49024-3316
(269) 599-0849
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401007982
MI
101YP2500X
Professional Counselor
Primary
6401007982
MI
101YS0200X
School Counselor
6401007982
MI
Other
Enumeration date
02/10/2016
Last updated
01/12/2017
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