Individual
MS. JENNY JACQUELINE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
8623 N WAYNE RD STE 310, WESTLAND, MI 48185-1137
(734) 425-0636
Mailing address
11355 EASTSIDE DR, PLYMOUTH, MI 48170-4330
(805) 218-6002
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5301013221
MI
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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