Organization
BLUEWATER COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH HOUPT (CREDENTIALING)
(517) 676-9788
Entity
Organization
Contact information
Practice address
1611 W CENTRE AVE STE 107, PORTAGE, MI 49024-5339
(269) 366-0979
Mailing address
PO BOX 10, MASON, MI 48854-0010
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
07/03/2019
Last updated
07/03/2019
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