Healthcare Provider Details

I. General information

NPI: 1972426971
Provider Name (Legal Business Name): TINA MARIA ORLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6816 BRIDLE TRL
RICHLAND MI
49083-9777
US

IV. Provider business mailing address

6816 BRIDLE TRL
RICHLAND MI
49083-9777
US

V. Phone/Fax

Practice location:
  • Phone: 734-752-1622
  • Fax:
Mailing address:
  • Phone: 734-752-1622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401224076
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: