Individual
MR. J THOMAS MUNLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C., N.C.C.
Contact information
Practice address
168 E CENTER ST, ITHACA, MI 48847-1436
(989) 875-0284
Mailing address
9724 LAKEVIEW CT, PERRINTON, MI 48871-8600
(517) 706-7311
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401012859
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13653731
CAQH
MI
Enumeration date
11/11/2015
Last updated
11/14/2015
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