Individual
MISS CAROLYN JOYCE MACOMBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1011 BROADWAY ST STE 10, NILES, MI 49120-2762
(269) 485-1505
Mailing address
1011 BROADWAY ST STE10, NILES, MI 49120-2762
(269) 845-1505
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401013902
MI
101YP2500X
Professional Counselor
Primary
6401013902
MI
Other
Enumeration date
05/05/2014
Last updated
08/08/2017
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