Organization
MINDFUL MOON MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACI L HISSONG MA, LPC (OWNER/THERAPIST)
(734) 564-0019
Entity
Organization
Contact information
Practice address
8316 HOLLY DR, CANTON, MI 48187-4238
(734) 564-0019
Mailing address
8316 HOLLY DR, CANTON, MI 48187-4238
(734) 564-0019
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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