Organization
NEW AGE CONSULTATION
Active
Other names
New Age Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
IZAYAH T NEWSOM LLPC (OWNER)
(574) 855-0009
Entity
Organization
Contact information
Practice address
1389 W MAPLE AVE APT C4, ADRIAN, MI 49221-1354
(574) 855-0009
Mailing address
1389 W MAPLE AVE APT C4, ADRIAN, MI 49221-1354
(574) 855-0009
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/18/2022
Last updated
03/18/2022
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