Healthcare Provider Details

I. General information

NPI: 1760390140
Provider Name (Legal Business Name): MRS. JAELENE JESSICA CLAESSENS-HARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAELENE JESSICA CLAESSENS

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MILLS AVE
NORTH MUSKEGON MI
49445-3014
US

IV. Provider business mailing address

16980 130TH AVE
NUNICA MI
49448-9615
US

V. Phone/Fax

Practice location:
  • Phone: 231-719-4240
  • Fax:
Mailing address:
  • Phone: 616-502-3391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101003057
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: