Organization
EVOLVE PSYCHOTHERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE LAFOREST (AGENT)
(313) 633-4358
Entity
Organization
Contact information
Practice address
2030 PACKARD ST STE B, ANN ARBOR, MI 48104-4785
(708) 663-6279
Mailing address
2030 PACKARD ST STE B, ANN ARBOR, MI 48104-4785
(708) 663-6279
(734) 648-0581
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
6801093987
MI
Other
Enumeration date
07/10/2017
Last updated
06/29/2023
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