Organization
EMERGING WHOLE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SUPERSON (CLINICAL LMSW)
(231) 715-1710
Entity
Organization
Contact information
Practice address
820 W FRONT ST, TRAVERSE CITY, MI 49684-2466
(231) 715-1710
Mailing address
9283 S NOVAK RD, CEDAR, MI 49621-9792
(231) 715-1710
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
6801100021
MI
Other
Enumeration date
03/07/2018
Last updated
03/26/2018
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