Provider Demographics
NPI:1033375803
Name:DELMOTTE, JENNIFER SHAFER (LLPC, FAODP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SHAFER
Last Name:DELMOTTE
Suffix:
Gender:F
Credentials:LLPC, FAODP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 E 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-2026
Mailing Address - Country:US
Mailing Address - Phone:248-548-4044
Mailing Address - Fax:248-548-9239
Practice Address - Street 1:1424 E 11 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2026
Practice Address - Country:US
Practice Address - Phone:248-548-4044
Practice Address - Fax:248-548-9239
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010955101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional