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Organization

COUNTRY-SIDE COUNSELING & CONSULTATION SERVICES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROGER DALE BAYNE L.P.C (PRESIDENT)
(231) 571-0082
Entity
Organization

Contact information

Practice address
388 N 3RD AVE, SUITE F, FRUITPORT, MI 49415-9785
(231) 571-0082
Mailing address
388 N 3RD AVE, SUITE F, FRUITPORT, MI 49415-9785
(231) 571-0082

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
04/08/2010
Last updated
10/27/2016
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