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Individual

PAULA GENE HERZOG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPC

Contact information

Practice address
6459 W M 72 HWY, GRAYLING, MI 49738-8021
(989) 348-2544
(989) 348-7617
Mailing address
6459 W M 72 HWY, GRAYLING, MI 49738-8021
(989) 348-2544
(989) 348-7617

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401014194
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38-2762492
MI
Enumeration date
09/11/2018
Last updated
09/11/2018
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