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Individual

INDIA SPRINGS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LLPC

Contact information

Practice address
17510 BREWER RD, DUNDEE, MI 48131-9678
(419) 379-1779
Mailing address
PO BOX 209, DUNDEE, MI 48131-0209

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401016199
MI
101YS0200X
School Counselor
21412617
OH
106S00000X
Behavior Technician
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
07/24/2017
Last updated
07/24/2017
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