Individual
MR. JUSTIN FITTONNEVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC, NCC
Contact information
Practice address
4000 W WALTON BLVD STE A&B, WATERFORD, MI 48329-4191
(248) 461-6266
Mailing address
4000 W WALTON BLVD STE A, WATERFORD, MI 48329-4191
(248) 461-6266
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401014329
MI
Other
Enumeration date
12/17/2018
Last updated
08/08/2019
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