Organization
MINDFUL LIVING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBBIE KOELTZOW ED.D., LP (CLINIC DIRECTOR)
(734) 657-8059
Entity
Organization
Contact information
Practice address
810 E GRAND RIVER AVE STE 101, BRIGHTON, MI 48116-1878
(810) 588-4236
(810) 588-4247
Mailing address
2460 CARRIAGE WAY, YPSILANTI, MI 48197-7423
(734) 657-8059
(810) 588-4247
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301011430
MI
Other
Enumeration date
06/30/2009
Last updated
06/30/2009
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