Organization
WILLOWS EDGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN RENEE SMIGELSKI LPC (OWNER / COUNSELOR)
(248) 894-4911
Entity
Organization
Contact information
Practice address
81 INDIANWOOD RD, LAKE ORION, MI 48362-1595
(248) 894-4911
Mailing address
PO BOX 311, LAKE ORION, MI 48361-0311
(248) 894-4911
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6401009232
MI
Other
Enumeration date
01/19/2011
Last updated
01/19/2011
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