Organization
CHILD & FAMILY THERAPY CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACHELLE ALYCE SHERBURNE LMSW (CLINICAL THERAPIST)
(269) 352-3558
Entity
Organization
Contact information
Practice address
114 VINE ST, GOBLES, MI 49055-9693
(269) 352-3558
Mailing address
114 VINE ST, P.O. BOX 373, GOBLES, MI 49055-9693
(269) 352-3558
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6801090517
MI
Other
Enumeration date
03/20/2012
Last updated
03/20/2012
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