Provider Demographics
NPI:1518530765
Name:SCHROEDER-PARKER, JENNIFER J (COUNSELOR)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:J
Last Name:SCHROEDER-PARKER
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6061 TEXTILE RD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-8990
Mailing Address - Country:US
Mailing Address - Phone:734-834-6934
Mailing Address - Fax:
Practice Address - Street 1:6061 TEXTILE RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-8990
Practice Address - Country:US
Practice Address - Phone:734-834-6934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2-00953101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty