Individual
MS. JESSICA LOUISE BLODGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
4576 W WALTON BLVD, WATERFORD, MI 48329-4905
(248) 742-1963
Mailing address
13730 S 28TH ST, VICKSBURG, MI 49097-9304
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401017014
MI
Other
Enumeration date
01/18/2019
Last updated
01/18/2019
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