Individual
JACOB PETRIMOULX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
44899 CENTRE CT STE 101, CLINTON TOWNSHIP, MI 48038-5510
(586) 690-8331
Mailing address
11837 DANFORTH DR, STERLING HEIGHTS, MI 48312-2128
(586) 978-2265
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451022247
MI
Other
Enumeration date
03/03/2016
Last updated
03/14/2023
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