Individual
MRS. JESSICA MARIE CLOUTIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LPC
Contact information
Practice address
640 3 MILE RD NW, GRAND RAPIDS, MI 49544-8209
(616) 785-8900
Mailing address
1939 DIVISION AVE S, GRAND RAPIDS, MI 49507-2459
(616) 247-3815
(616) 245-0450
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401011184
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4483587
—
MI
Enumeration date
01/11/2010
Last updated
11/08/2018
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