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General NPI Number Information
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NPI Number | 1083524441
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Entity Type | Organization
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Legal Business Name | THE MAGNOLIA THERAPY CENTER, LLC
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Dates
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Enumeration Date | 09/09/2026
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Last Update Date | 09/09/2026
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Provider Practice Location Address
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Address Line | 1693 W HAMLIN RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3312
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Country | US
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Telephone | 248-905-1862
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Fax |
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Provider Business Mailing Address
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Address Line | 1693 W HAMLIN RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3312
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY GREENE
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Credential | MA, LPC
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Telephone | 313-439-4782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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