Organization
FREY THERAPY LLC
Active
Other names
Spring Tide Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA FREY MA (OWNER)
(419) 345-7404
Entity
Organization
Contact information
Practice address
1591 W CENTRE AVE STE 205, PORTAGE, MI 49024-6315
(269) 525-4004
Mailing address
2596 CHESTNUT RIDGE AVE, PORTAGE, MI 49024-7600
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
05/31/2022
Last updated
06/13/2022
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