Organization
ANXIETY DISORDERS CBT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH HOUPT (CREDENTIALING)
(517) 676-9788
Entity
Organization
Contact information
Practice address
214 S BRIDGE ST STE C, GRAND LEDGE, MI 48837-1587
(810) 772-4351
Mailing address
PO BOX 10, MASON, MI 48854-0010
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301011111
MI
Other
Enumeration date
03/14/2018
Last updated
08/06/2019
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