Individual
JENNIFER ROSE MAISE-CORMIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
16532 COUNTRY CLUB DR, LIVONIA, MI 48154-2174
(248) 672-1712
Mailing address
16532 COUNTRY CLUB DR, LIVONIA, MI 48154-2174
(248) 672-1712
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6401002070
MI
101YP2500X
Professional Counselor
Primary
6401002070
MI
Other
Enumeration date
05/31/2009
Last updated
05/31/2009
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