Healthcare Provider Details

I. General information

NPI: 1396936100
Provider Name (Legal Business Name): CYNTHIA LOUISE HUBER-BADOUR L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 S WASHINGTON ST
OWOSSO MI
48867-2921
US

IV. Provider business mailing address

123 S WASHINGTON ST
OWOSSO MI
48867-2921
US

V. Phone/Fax

Practice location:
  • Phone: 989-723-0330
  • Fax: 989-723-0327
Mailing address:
  • Phone: 989-723-0330
  • Fax: 989-723-0327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401009299
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: