Healthcare Provider Details

I. General information

NPI: 1497101695
Provider Name (Legal Business Name): JJL CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 07/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 HURON AVE STE B
PORT HURON MI
48060-3869
US

IV. Provider business mailing address

309 HURON AVE STE B
PORT HURON MI
48060-3869
US

V. Phone/Fax

Practice location:
  • Phone: 810-689-9899
  • Fax:
Mailing address:
  • Phone: 810-689-9899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801059005
License Number StateMI

VIII. Authorized Official

Name: MS. JULIE ANN JOWETT-LEE
Title or Position: OWNER
Credential: CLMSW
Phone: 810-689-9899