Individual
JASON ANDREW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA TLLP LLPC
Contact information
Practice address
496 W ANN ARBOR TRL STE 101, PLYMOUTH, MI 48170-6262
(734) 347-6562
Mailing address
11536 ASPEN DR, PLYMOUTH, MI 48170-4597
(734) 347-6562
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6451023628
MI
103T00000X
Psychologist
Primary
6362009926
MI
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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