NPI | 1336340140 |
---|---|
Professional Name | JERRY B. VANLEEUWEN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301003978) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling |
103TF0000X Psychologist, Family (Licence: MI 4101000398) | |
Enumeration Date | 2007-05-30 |
Last Update Date | 2024-01-31 |