Organization
AUTHENTIC LIFE COUNSELING AND WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA WIERSEMA LMSW (OWNER)
(231) 714-0292
Entity
Organization
Contact information
Practice address
1200 W ELEVENTH ST, SUITE 218, TRAVERSE CITY, MI 49684-3287
(231) 714-0292
Mailing address
13554 S HIGH POINT DR, TRAVERSE CITY, MI 49684-5534
(231) 714-0292
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801093573
MI
Other
Enumeration date
01/21/2017
Last updated
01/21/2017
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