Organization
MICHELLE WAHULA, LMSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE WAHULA LMSW (LICENSED THERAPIST)
(586) 894-8410
Entity
Organization
Contact information
Practice address
228 N MAIN ST, SUITE F, ROMEO, MI 48065-4616
(586) 894-8410
Mailing address
228 N MAIN ST, SUITE F, ROMEO, MI 48065-4616
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
6801094043
MI
261QM0850X
Adult Mental Health Clinic/Center
6801094043
MI
261QM0855X
Adolescent and Children Mental Health Clinic/Center
6801094043
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801094043
STATE LICENSURE
MI
Enumeration date
11/04/2014
Last updated
11/04/2014
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