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Edward Mancile Jefferson JR.
Professional Counselor in Lansing, Michigan
NPI 1891203998

Edward Mancile Jefferson JR. is a Professional Counselor based in Lansing, MI and is specialized in Professional. Edward Mancile Jefferson JR. practices in Lansing, MI. The NPI Number for Edward Mancile Jefferson JR. is 1891203998 and holds a License No. 6401015665 (Michigan).

The current practice location address for Edward Mancile Jefferson JR. is 2800 W Willow St, Lansing, MI and can be reached out via phone at 517-323-4734 and via fax at 517-886-1158.

Location: 2800 W Willow St, Lansing, MI, 48917-1833
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1891203998
Provider Name
Edward Mancile Jefferson JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
2800 W Willow St, Lansing, MI, 48917-1833
Phone Number
517-323-4734
Fax Number
517-886-1158
Provider Enumeration Date
01/11/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6401015664 05 MI
institution
Provider Business Practice Location Address Details
Address
2800 W Willow St
City
Lansing
State
Michigan
Zip
48917-1833
Phone Number
517-323-4734
Fax Number
517-886-1158
person
Provider Business Mailing Address Details
Address
2800 W Willow St
City
Lansing
State
Michigan
Zip
48917-1833
Phone Number
517-323-4734
Fax Number
517-886-1158
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
6401015665 (Michigan)
Definition
Definition to come...
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