Individual
JENNIFER ALEJANDRA LANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1505 WATERFORD PKWY, SAINT JOHNS, MI 48879-9630
(989) 292-3572
Mailing address
1505 WATERFORD PKWY, SAINT JOHNS, MI 48879-9630
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362008896
MI
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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