Individual
JENNIFER FULLER BOHANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
7310 WOODWARD AVE, DETROIT, MI 48202-3165
(313) 896-1444
(313) 872-0804
Mailing address
7310 WOODWARD AVE, DETROIT, MI 48202-3165
(313) 896-1444
(313) 872-0804
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401012213
MI
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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