Individual
MRS. REBECCA ANNE LONGSTREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
13001 23 MILE RD STE 103, SHELBY TOWNSHIP, MI 48315
(248) 762-4011
Mailing address
13425 BERNADETTE CT, STERLING HEIGHTS, MI 48313-3403
(248) 762-4011
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401013232
MI
101YM0800X
Mental Health Counselor
6401013232
MI
Other
Enumeration date
09/26/2013
Last updated
11/12/2021
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