Healthcare Provider Details

I. General information

NPI: 1689357600
Provider Name (Legal Business Name): HALIE PLATTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 STIRLING AVE
LANSING MI
48910-1314
US

IV. Provider business mailing address

1612 STIRLING AVE
LANSING MI
48910-1314
US

V. Phone/Fax

Practice location:
  • Phone: 151-728-2785
  • Fax:
Mailing address:
  • Phone: 151-728-2785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: