| Doctor Name: | PAUL JANNAKOS |
| NPI Number: | 1023385481 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | L118310 |
| Business Practice Address: | 2325 W Shiawassee Ave Suite 105 Fenton, MI - 484301792 |
| Business Phone Number: | 8109658670 |
| Business Fax Number: | 8102130132 |
| Mailing Address: | 2325 W Shiawassee Ave, Suite 105 FENTON |
| State: | MI |
| Postal Code: | 484301792 |
| Phone Number: | 8106292500 |
| Fax Number: | |
| NPI Enumeration Date: | 11/29/2011 |
| NPI Last Update Date: | 10/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | L118310 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |