Doctor Name: | MRS. JENNIE SUE AYLOR |
NPI Number: | 1023445525 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. L.P.C |
License Number: | 6401011468 |
Business Practice Address: | 5353 Grand Haven Rd Suite B Norton Shores, MI - 494415985 |
Business Phone Number: | 2312159684 |
Business Fax Number: | |
Mailing Address: | 5353 Grand Haven Rd, Suite B NORTON SHORES |
State: | MI |
Postal Code: | 494415985 |
Phone Number: | 2312159684 |
Fax Number: | |
NPI Enumeration Date: | 09/30/2013 |
NPI Last Update Date: | 09/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6401011468 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |