Individual
JENNIFER ANN KODRIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
42189 ANN ARBOR RD E, PLYMOUTH, MI 48170-4370
(734) 453-5603
(734) 453-5619
Mailing address
45177 PRESTBURY RD, CANTON, MI 48187-2979
(734) 453-5603
(734) 453-5619
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301013094
MI
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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