Healthcare Provider Details

I. General information

NPI: 1407586993
Provider Name (Legal Business Name): HYACINTH HEALING CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 06/16/2022
Certification Date: 06/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8705 E MONROE RD
BRITTON MI
49229-9786
US

IV. Provider business mailing address

PO BOX 243
BRITTON MI
49229-0243
US

V. Phone/Fax

Practice location:
  • Phone: 734-881-4839
  • Fax:
Mailing address:
  • Phone: 734-881-4839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MELISSA WINKLER
Title or Position: OWNER
Credential: LMSW
Phone: 734-881-4839