Organization
MAGNOLIA THERAPY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA MARIE CHITTENDEN LCSW (OWNER)
(616) 446-2265
Entity
Organization
Contact information
Practice address
1731 VAN DYKE ST APT 1, DETROIT, MI 48214-2633
(616) 446-2265
Mailing address
269 WALKER ST STE 122, DETROIT, MI 48207-4258
(616) 446-2265
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/01/2021
Last updated
09/20/2021
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