MEDICARE: JENNIFER MONETTE M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	6401009863	MI

General Provider Information

NPI Number	:	1912157298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MONETTE M.A.

Provider Business Mailing Address
First Line	:	2841 MELVIN AVE
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-4866
Country	:	US
Telephone Number	:	248-853-5284
Fax Number	:

Provider Business Practice Location Address
First Line	:	2841 MELVIN AVE
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-4866
Country	:	US
Telephone Number	:	248-853-5284
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2008
Last Update Date	:	09/24/2008

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