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Individual

MR. JASON ANDREW GIANNINI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.P.C.

Contact information

Practice address
3604 CLARKSTON RD # 102, CLARKSTON, MI 48348-5215
(800) 693-1916
Mailing address
344 WORDSWORTH ST, FERNDALE, MI 48220-2580
(248) 892-5477

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401007454
MI
101YP2500X
Professional Counselor
6401007454
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
583632350
HPSO
Enumeration date
04/03/2012
Last updated
09/20/2018
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