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General NPI Number Information
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NPI Number | 1053123026
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Entity Type | Organization
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Legal Business Name | THE BODY PRINCIPLE LLC
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 62581 HILLCREST DR
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City | WASHINGTON
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State | MI
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Zip | 48094-1339
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Country | US
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Telephone | 248-895-8718
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Fax |
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Provider Business Mailing Address
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Address Line | 145 S LIVERNOIS RD # 304
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-1837
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Country | US
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Telephone | 248-688-0755
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. ANGELA MOORE
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Credential | LPC
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Telephone | 248-895-8718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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