Individual
MRS. MIRIAM E IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LLP
Contact information
Practice address
1485 S M-139, BENTON HARBOR, MI 49022
(269) 925-0585
(269) 927-1326
Mailing address
1485 S M-139, BENTON HARBOR, MI 49022
(269) 925-0585
(269) 927-1326
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401007990
MI
103TB0200X
Cognitive & Behavioral Psychologist
6301011675
MI
Other
Enumeration date
11/15/2006
Last updated
03/18/2014
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