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Organization
HOLISTIC VIDA THERAPY
Active
Organization
HOLISTIC VIDA THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILLAMI ROMERO MARTINEZ LMFT (OWNER)
(517) 944-1262
Entity
Organization
Contact information
Practice address
3610 LAUREATE DR, HOLT, MI 48842-9422
(517) 455-7555
Mailing address
119 PERE MARQUETTE DR STE 2D, LANSING, MI 48912-1270
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
06/08/2020
Last updated
11/26/2024
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