Individual
DEBRA A IMBROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LPC, CAADC
Contact information
Practice address
5380 HOLIDAY TER, SUITE 47, KALAMAZOO, MI 49009-2154
(269) 365-7672
Mailing address
5380 HOLIDAY TER, SUITE 47, KALAMAZOO, MI 49009-2154
(269) 365-7672
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401005563
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134244873
TAX ID
MI
Enumeration date
08/07/2006
Last updated
03/01/2017
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