Individual
MRS. JACQUELINE MARLENE SOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
1409 S GRAHAM RD, FLINT, MI 48532-3538
(810) 217-1024
Mailing address
13275 LAKE SHORE DR, FENTON, MI 48430-1019
(810) 629-3882
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6301013661
MI
Other
Enumeration date
04/14/2008
Last updated
03/30/2010
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