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Organization

J FLACK PSYD PC

Active
Other names
Fenton Wellness
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JENNIFER FLACK PSY.D., LP (PRESIDENT)
(810) 309-9355
Entity
Organization

Contact information

Practice address
127 N RIVER ST, FENTON, MI 48430-3800
(810) 309-9355
Mailing address
127 N RIVER ST, FENTON, MI 48430-3800
(810) 309-9355

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401006094
MI
103T00000X
Psychologist
Primary
6301014240
MI
104100000X
Social Worker
6801006671
MI

Other

Enumeration date
03/30/2012
Last updated
01/22/2025
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