Organization · NPI-2

Abundant Wellness, PLLC

Social Worker, Clinical · Saint Clair Shores, MI

NPI number1508282336
StatusActive
Last updated in NPPESMar 18, 2014

Details

NPI
1508282336
Entity type
Organization (NPI-2)
Legal business name
Abundant Wellness, PLLC
Organization subpart
No
Enumeration date
Mar 18, 2014
Last updated
Mar 18, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical680190677MIYes

Practice location

23409 Jefferson Ave
Suite 100
Saint Clair Shores, MI 48080-3449

Phone 586-914-5914 · Fax 313-458-7128

Mailing address

813 Crescent Ln
Grosse Pointe Woods, MI 48236-2701

Phone 586-914-5914 · Fax 313-458-7128

Authorized official

Amy Lyn Lawrence
Owner
5869145914

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