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1891203998
EDWARD MANCILE JEFFERSON
LANSING, MI
NPI
1891203998
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: MI 6401015665)
Enumeration Date
2018-01-11
Last Update Date
2018-01-11
Business Address
EDWARD MANCILE JEFFERSON
2800 W WILLOW ST
LANSING, MI 48917-1833
Phone number: 517-323-4734
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Mailing Address
EDWARD MANCILE JEFFERSON
2800 W WILLOW ST
LANSING, MI 48917-1833
Phone number: 517-323-4734
Copy
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