Individual
DR. JILL LESLIE KOFENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5119 HIGHLAND RD # 192, WATERFORD, MI 48327-1915
(248) 867-8766
Mailing address
5119 HIGHLAND RD # 192, WATERFORD, MI 48327-1915
(248) 867-8766
(248) 669-1925
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301012830
MI
103TC0700X
Clinical Psychologist
6301012830
MI
Other
Enumeration date
07/18/2007
Last updated
10/31/2024
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