Organization
LIFE RENEWAL NEWTWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY BROE PHD, MA, LPC (DIRECTOR)
(248) 474-2763
Entity
Organization
Contact information
Practice address
33634 W 8 MILE RD, FARMINGTON HILLS, MI 48335-5202
(248) 474-2763
(248) 476-4990
Mailing address
33634 W 8 MILE RD, FARMINGTON HILLS, MI 48335-5202
(248) 474-2763
(248) 476-4990
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401001490
MI
101YA0400X
Addiction (Substance Use Disorder) Counselor
6401001490
MI
101YP2500X
Professional Counselor
Primary
6401001490
MI
106H00000X
Marriage & Family Therapist
6401001490
MI
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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