Individual
JENELLE MAZARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 S MAIN ST, SUITE 280, PLYMOUTH, MI 48170-2089
(734) 454-3560
(734) 454-3570
Mailing address
3694 CLARKSTON RD, SUITE D, CLARKSTON, MI 48348-5213
(248) 410-0650
(248) 391-7478
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4101006577
MI
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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