Organization
ILLUMINATION PSYCHOTHERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARRETT SHOTWELL (OWNER)
(773) 318-7304
Entity
Organization
Contact information
Practice address
450 S MAPLE RD STE 858, ANN ARBOR, MI 48103-3835
(773) 318-7304
Mailing address
1715 ABBOTT AVE, ANN ARBOR, MI 48103-4107
(773) 318-7304
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/31/2024
Last updated
02/15/2024
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