Individual
JUDY LYN JENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Contact information
Practice address
5020 E BELTLINE AVE NE STE 202, GRAND RAPIDS, MI 49525-6869
(616) 439-1866
Mailing address
6580 CREEKSTONE LN SW APT 101, GRAND RAPIDS, MI 49548-7868
(616) 915-5572
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451017415
MI
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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