Organization
RESET BRAIN PLUS BODY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY BISKELONIS (OWNER)
(734) 531-8563
Entity
Organization
Contact information
Practice address
409 PLYMOUTH RD STE 180, PLYMOUTH, MI 48170-1493
(734) 531-8563
Mailing address
409 PLYMOUTH RD STE 180, PLYMOUTH, MI 48170-1493
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
133V00000X
Registered Dietitian
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2019
Last updated
06/11/2019
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