Organization
INSIGHT FOR LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE C VIVES NP (OWNER)
(734) 845-2151
Entity
Organization
Contact information
Practice address
7255 PEACHTREE CT, CANTON, MI 48187-1467
(734) 845-2151
(248) 544-9040
Mailing address
7255 PEACHTREE CT, CANTON, MI 48187-1467
(734) 845-2151
(248) 544-9040
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4704254270
MI
Other
Enumeration date
11/28/2012
Last updated
07/08/2013
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