Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6401008655 | MI |
NPI | 1003127069 |
---|---|
Provider Name | Jennifer Bobicz |
First Address | Dundee, MI 48131-9721 |
Second Address | Lambertville, MI 48144-9456 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2010 |
Last Update Date | 28/01/2022 |