Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 6401011399 | MI |
N | 101YS0200X | School Counselor | 187882 | MI |
NPI | 1144567496 |
---|---|
Provider Name | Mrs. Jennifer Anne Meador |
First Address | Grand Rapids, MI 49506-2728 |
Second Address | Grand Rapids, MI 49506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2013 |
Last Update Date | 07/01/2013 |