Healthcare Provider Details

I. General information

NPI: 1679787113
Provider Name (Legal Business Name): REBECCA FILIP LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 W MICHIGAN AVE
JACKSON MI
49201-2120
US

IV. Provider business mailing address

PO BOX 67000 DEPARTMENT 272801
DETROIT MI
48267-2728
US

V. Phone/Fax

Practice location:
  • Phone: 517-783-2732
  • Fax: 517-783-2359
Mailing address:
  • Phone: 517-841-6913
  • Fax: 517-841-6917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6802059283
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: