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General NPI Number Information
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NPI Number | 1770009110
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Entity Type | Organization
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Legal Business Name | JEWELS OF HOPE, LLC
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5229 W MICHIGAN AVE
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City | YPSILANTI
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State | MI
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Zip | 48197-8887
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Country | US
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Telephone | 734-883-4812
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Fax | 734-434-2043
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Provider Business Mailing Address
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Address Line | 5229 W. MICHIGAN AVE 185
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City | YPSILANTI
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State | MI
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Zip | 48197
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Country | US
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Telephone | 734-883-4812
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Fax | 734-434-2043
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Authorized Official
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Title or Position | LPC
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Name | JEWEL MCGOWAN
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Credential | LPC
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Telephone | 734-883-4812
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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 | 6401008396
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License Number State | MI
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