Individual
ANNA ECCLESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8080 MOORSBRIDGE RD, PORTAGE, MI 49024-4421
(269) 548-9868
Mailing address
802 NEWGATE RD, KALAMAZOO, MI 49006-2714
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401017667
MI
Other
Enumeration date
09/12/2019
Last updated
01/08/2024
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