Individual
MRS. MACHELLE DIA VIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLMFT
Contact information
Practice address
304 W MICHIGAN AVE, PAW PAW, MI 49079-1012
(269) 998-4388
Mailing address
68155 26TH ST, LAWTON, MI 49065-9615
(269) 998-4388
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4101006450
MI
Other
Enumeration date
05/27/2010
Last updated
11/03/2010
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