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Organization

FULFILLING LIFE'S YEARNINGS MENTAL HEALTH CENTER, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BLAKE SOULET LLC (OWNER)
(248) 736-7541
Entity
Organization

Contact information

Practice address
5756 REVETON RD, WEST BLOOMFIELD, MI 48322-1357
(248) 736-7541
Mailing address
5756 REVETON RD, WEST BLOOMFIELD, MI 48322-1357
(248) 736-7541

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
03/31/2025
Last updated
03/31/2025
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