Organization
RISE OF THE PHOENIX COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH HOUPT (CREDENTIALING)
(517) 676-9797
Entity
Organization
Contact information
Practice address
2265 LIVERNOIS RD STE 410, TROY, MI 48083-1606
(248) 417-3783
Mailing address
PO BOX 10, MASON, MI 48854-0010
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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