Jack D Woodburn LPC

NPI 1306009196 - Counselor - 101YP2500X

NPI Details
NPI 1306009196
Gender Male
Enumeration Date 07/02/2008
Last Updated 07/02/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
1101 MILITARY ST
PORT HURON MI, 48060-5418, US
Phone (810) 984-5575
Fax (810) 984-6433
Business Location
1101 MILITARY ST
PORT HURON MI, 48060-5418, US
Phone (810) 984-5575
Fax (810) 984-6433
Toxanomy
Taxonomy Code 101YP2500X
License State Michigan
License Number 6401000326
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According to our database, Mr. Jack D Woodburn LPC NPI is 1306009196, taxonomy code is 101YP2500X and license number is 6401000326, license state is located at Michigan. Jack D Woodburn LPC physically located at 1101 Military St, Port Huron MI, 48060-5418. NPI Number Jack D Woodburn LPC has the Individual type.

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1306009196 NPI number is provided on an as is basis without warranty of any kind. 1306009196 is maintained by the National Plan & Provider Enumeration System. The contents of Jack D Woodburn LPC are for informational purposes only.