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1326888793
THEODORE JAY
EAST LANSING, MI
NPI
1326888793
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6851117852)
Enumeration Date
2024-05-31
Last Update Date
2024-05-31
Business Address
THEODORE JAY LLMSW
2970 E LAKE LANSING RD
EAST LANSING, MI 48823-7415
Phone number: 517-258-1374
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Mailing Address
THEODORE JAY LLMSW
4115 MAR MOOR DR
LANSING, MI 48917-1613
Phone number: 773-318-2296
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