Healthcare Provider Details

I. General information

NPI: 1972356848
Provider Name (Legal Business Name): HEJIRA THERAPY P.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 HYLAND ST
FERNDALE MI
48220-1242
US

IV. Provider business mailing address

PO BOX 20532
FERNDALE MI
48220-0532
US

V. Phone/Fax

Practice location:
  • Phone: 616-485-9855
  • Fax:
Mailing address:
  • Phone: 616-485-9855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ALISHA WHITNEY
Title or Position: OWNER
Credential: LMSW, CAADC
Phone: 616-485-9855