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Organization
ACES PEDIATRIC BEHAVIORAL HEALTH PLLC
Active
Organization
ACES PEDIATRIC BEHAVIORAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMYRA N COOPER LCSW (CLINICAL DIRECTOR)
(231) 268-1149
Entity
Organization
Contact information
Practice address
10823 N STRAITS HWY STE B, CHEBOYGAN, MI 49721-9077
(231) 268-1149
(231) 268-3369
Mailing address
PO BOX 122, CHEBOYGAN, MI 49721-0122
(231) 268-1149
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265098693
—
MI
Enumeration date
10/14/2022
Last updated
01/28/2023
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