Individual
JUSTIN PERSOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1686 N LAKESHORE DR, LUDINGTON, MI 49431-9403
(231) 233-6576
(231) 845-7095
Mailing address
1686 N LAKESHORE DR, LUDINGTON, MI 49431-9403
(231) 233-6576
(231) 845-7095
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401013191
MI
103K00000X
Behavior Analyst
1-16-22081
MI
103T00000X
Psychologist
Primary
6301015191
MI
Other
Enumeration date
09/05/2012
Last updated
01/09/2017
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