Provider Information for 1114389194
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JEANNIE CRAIG TLLP, LLPC
Sex: Female
NPI: 1114389194
Last Updated: 2024-03-26
Certification Date: 2024-03-26
Certification Date: 2024-03-26
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1114389194 | ||||||||||||
| Enumeration Date | 2016-03-28 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3383 S LAPEER RD METAMORA, MI 48455-8968 United States Phone: 810-406-1660 | Fax:248-970-0210 | ||||||||||||
| Primary Practice Address | 3383 S LAPEER RD METAMORA, MI 48455-8968 United States Phone: 810-406-1660 | Fax:248-970-0210 | ||||||||||||
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