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Individual

CHARLIZE TAE WHITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
100 MALTON RD STE 8, NEGAUNEE, MI 49866-2002
(906) 485-2347
Mailing address
97 S 4TH ST, ISHPEMING, MI 49849-2168
(906) 228-9699

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
07/10/2023
Last updated
07/10/2023
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