Organization
BRIGHT WHITE WAVE HEALING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENEVIEVE TAYLOR LPC (DIRECTOR)
(248) 766-2036
Entity
Organization
Contact information
Practice address
96 LYNDON CIR, OAKLAND, MI 48363-1322
(248) 766-2036
Mailing address
96 LYNDON CIR, OAKLAND, MI 48363-1322
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295079689
—
MI
Enumeration date
08/04/2019
Last updated
08/04/2019
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