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1336717123
JENNIFER C BLAISDELL
LIVONIA, MI
NPI
1336717123
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Former Name
JENNIFER CIVITA HARDEN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6801095531)
Enumeration Date
2021-06-16
Last Update Date
2021-06-16
Business Address
JENNIFER C BLAISDELL
14392 HUBBARD ST
LIVONIA, MI 48154-4146
Phone number: 734-765-3842
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Mailing Address
JENNIFER C BLAISDELL
231 STATE ST STE 6
PETOSKEY, MI 49770-2785
Phone number: 231-881-9125
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