Individual
LAUREN ELYSE PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7678 COTTONWOOD DR, JENISON, MI 49428
(616) 426-9034
Mailing address
7678 COTTONWOOD DR, JENISON, MI 49428-7312
(616) 426-9034
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401015673
MI
Other
Enumeration date
10/18/2016
Last updated
09/11/2019
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