Provider Demographics
NPI:1295051514
Name:SANCHEZ-DELEON, JOELL LAVONNE (LLP)
Entity type:Individual
Prefix:
First Name:JOELL
Middle Name:LAVONNE
Last Name:SANCHEZ-DELEON
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:JOELL
Other - Middle Name:LAVONNE
Other - Last Name:KLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLP
Mailing Address - Street 1:6692 SPRING ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-9322
Mailing Address - Country:US
Mailing Address - Phone:517-750-3869
Mailing Address - Fax:517-750-3673
Practice Address - Street 1:6692 SPRING ARBOR RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-9322
Practice Address - Country:US
Practice Address - Phone:517-750-3869
Practice Address - Fax:517-750-3673
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009590103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical