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Organization

EMOTIONAL COMFORTWEAR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDISON KONAN (MASSAGE THERAPIST)
(734) 720-2097
Entity
Organization

Contact information

Practice address
15450 HEATHERWOOD, SOUTHGATE, MI 48195-8523
(734) 720-2097
Mailing address
15450 HEATHERWOOD, SOUTHGATE, MI 48195-8523
(734) 720-2097

Taxonomy

Speciality
Code
Description
License number
State
101200000X
Drama Therapist
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YS0200X
School Counselor
102X00000X
Poetry Therapist
103T00000X
Psychologist
103TB0200X
Cognitive & Behavioral Psychologist
103TC1900X
Counseling Psychologist
103TF0000X
Family Psychologist
103TP2701X
Group Psychotherapy Psychologist
106H00000X
Marriage & Family Therapist
111N00000X
Chiropractor
172A00000X
Driver
225700000X
Massage Therapist
Primary

Other

Enumeration date
01/08/2024
Last updated
01/08/2024
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