Organization
BRIDGEWAY WELLNESS COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH ANN DECKER-MILLER L.L.P, L.P.C. (DIRECTOR)
(269) 370-3822
Entity
Organization
Contact information
Practice address
225 BROADWAY ST, SUITE 7, SOUTH HAVEN, MI 49090-2408
(269) 370-3822
Mailing address
PO BOX 565, SOUTH HAVEN, MI 49090-0565
(269) 370-3822
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401002104
MI
101YP2500X
Professional Counselor
6401009590
MI
103T00000X
Psychologist
Primary
6301013683
MI
103TC0700X
Clinical Psychologist
6301006485
MI
104100000X
Social Worker
6802060565
MI
Other
Enumeration date
12/17/2007
Last updated
02/20/2008
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