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General NPI Number Information
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NPI Number | 1588310601
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Entity Type | Organization
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Legal Business Name | JENNIFER TABAR, LPC, LLC
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Dates
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Enumeration Date | 02/28/2022
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 4289 MARY ST
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City | WELLSTON
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State | MI
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Zip | 49689
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Country | US
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Telephone | 231-299-7986
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 176
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City | WELLSTON
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State | MI
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Zip | 49689-0176
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JENNIFER TABAR
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Credential |
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Telephone | 586-718-8222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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