Organization
BRAVE SOUL COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH HOUPT (CREDENTIALING)
(517) 676-9797
Entity
Organization
Contact information
Practice address
11126 WAYNE RD, ROMULUS, MI 48174-1473
(734) 322-9334
Mailing address
PO BOX 10, MASON, MI 48854-0010
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
04/01/2019
Last updated
05/21/2024
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