Individual
BETH ANNE LIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP LPC
Contact information
Practice address
15209 W MICHIGAN AVE, MARSHALL, MI 49068-9570
(269) 781-9119
(269) 789-4347
Mailing address
15209 W MICHIGAN AVE, MARSHALL, MI 49068-9570
(269) 781-9119
(269) 789-4347
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401003307
MI
103T00000X
Psychologist
Primary
6301006717
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7509107630
BCBS OF MI
MI
Enumeration date
09/25/2006
Last updated
12/05/2014
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