Individual
JENNIE TUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, CTRS, CDP
Contact information
Practice address
147 N 4TH AVE, FRUITPORT, MI 49415-9602
(616) 477-5618
Mailing address
147 N 4TH AVE, FRUITPORT, MI 49415-9602
(616) 477-5618
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
65762
MI
Other
Enumeration date
01/02/2019
Last updated
01/14/2024
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