Organization
CANYON INTEGRATIVE HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANA CANYON LMSW (CLINICAL THERAPIST)
(586) 277-3752
Entity
Organization
Contact information
Practice address
3716 NEWBERRY ST, WAYNE, MI 48184-2298
(586) 277-3752
Mailing address
PO BOX 384, WAYNE, MI 48184-0384
(586) 277-3752
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/17/2021
Last updated
12/17/2021
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