Healthcare Provider Details

I. General information

NPI: 1265200067
Provider Name (Legal Business Name): JOHN UVINO LLPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2536 SPRING ARBOR RD
JACKSON MI
49203-3602
US

IV. Provider business mailing address

2536 SPRING ARBOR RD
JACKSON MI
49203-3602
US

V. Phone/Fax

Practice location:
  • Phone: 517-998-0999
  • Fax: 517-998-0998
Mailing address:
  • Phone: 517-998-0999
  • Fax: 517-998-0998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451023408
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: