Individual
DEBRA LYNN THALISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, RSST, ICCJP, SAP
Contact information
Practice address
175 E ADAMS ST, IONIA, MI 48846-1672
(616) 527-5341
(616) 527-8247
Mailing address
3862 LYONS RD, LYONS, MI 48851-9774
(517) 647-1783
(616) 527-8247
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6803086569
MI
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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