Healthcare Provider Details

I. General information

NPI: 1083089395
Provider Name (Legal Business Name): JUDITH ANN PARROS M.A., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2015
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 S MAIN ST
ONSTED MI
49265-9768
US

IV. Provider business mailing address

236 S MAIN ST
ONSTED MI
49265-9768
US

V. Phone/Fax

Practice location:
  • Phone: 517-902-3987
  • Fax:
Mailing address:
  • Phone: 517-902-3987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401011437
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: