Organization
MCLAREN BAY REGION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE C JACKS PORTER (CFO)
(989) 894-3838
Entity
Organization
Contact information
Practice address
690 S TRUMBULL ST, BAY CITY, MI 48708
(989) 922-4900
Mailing address
690 S TRUMBULL ST, BAY CITY, MI 48708-7692
(989) 922-4900
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
05/21/2012
Last updated
08/08/2018
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