Individual
REBECCA LYNN BERONJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1125 E MILHAM AVE STE B, PORTAGE, MI 49002-3096
(269) 312-1446
Mailing address
140 MICHIGAN AVE W, BATTLE CREEK, MI 49017-3602
(269) 966-1460
(269) 979-7766
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401010825
MI
101YP2500X
Professional Counselor
Primary
6401010825
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401010825
LICENSE #
MI
Enumeration date
01/21/2010
Last updated
04/14/2023
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