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General NPI Number Information
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NPI Number | 1598247975
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Entity Type | Individual
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Provider Name | JONI MARIE CLEMONS
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Gender | Female
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Dates
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Enumeration Date | 09/03/2018
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Last Update Date | 10/04/2018
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Provider Practice Location Address
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Address Line | 1110 ELDON BAKER DR
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City | FLINT
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State | MI
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Zip | 48507-1923
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Country | US
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Telephone | 810-742-4968
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Fax |
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Provider Business Mailing Address
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Address Line | 9127 MAGNOLIA CT
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City | DAVISON
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State | MI
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Zip | 48423-2088
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Country | US
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Telephone | 810-516-4892
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401016796
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License Number State | MI
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