Organization
RISING PHOENIX PSYCHOLOGY AND COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH HOUPT (CREDENTIALING)
(517) 676-9797
Entity
Organization
Contact information
Practice address
123 S COCHRAN AVE STE D, CHARLOTTE, MI 48813-1509
(517) 997-6088
Mailing address
PO BOX 10, MASON, MI 48854-0010
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
05/22/2024
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