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Portage Life Coaching And Counseling LLP

Social Worker, Clinical in Portage, MI. Organization (NPI-2).

NPI number1366052011
StatusActive
Last updated in NPPESNov 27, 2023

Details

NPI
1366052011
Entity type
Organization (NPI-2)
Legal business name
Portage Life Coaching And Counseling LLP
Organization subpart
No
Enumeration date
Aug 7, 2020
Certification date
Aug 7, 2020
Last updated
Nov 27, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical––Yes

Practice location

10032 Shaver Rd
Portage, MI 49024-6738

Phone 269-993-9977

Mailing address

10032 Shaver Rd
Portage, MI 49024-6738

Authorized official

Gerald Brooks
Ceo
2694478758

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