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Individual

DIEATRA RENEE JONES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LLPC

Contact information

Practice address
17356 W 12 MILE RD, SOUTHFIELD, MI 48076-2128
(248) 996-8569
(248) 562-7119
Mailing address
17349 PARK LN, SOUTHFIELD, MI 48076-7716
(313) 477-1152

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401010766
MI

Other

Enumeration date
04/04/2019
Last updated
04/04/2019
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