Individual
MICHAEL JAMES FILLMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
497 WAUKONDA AVE, BENTON HARBOR, MI 49022-3142
(269) 926-1284
Mailing address
497 WAUKONDA AVE, BENTON HARBOR, MI 49022-3142
(269) 926-1284
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/03/2023
Last updated
03/20/2023
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