Doctor Name: | ERIN JELTEMA |
NPI Number: | 1053796185 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A, C.A.D.C |
License Number: | 6301015636 |
Business Practice Address: | 215 W Main St Ionia, MI - 488461638 |
Business Phone Number: | 6165220687 |
Business Fax Number: | |
Mailing Address: | 215 W Main St, IONIA |
State: | MI |
Postal Code: | 488461638 |
Phone Number: | 6165220687 |
Fax Number: | |
NPI Enumeration Date: | 07/30/2015 |
NPI Last Update Date: | 07/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 6301015636 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |