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General NPI Number Information
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NPI Number | 1144835166
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Entity Type | Organization
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Legal Business Name | ARTFULLY CENTERED, LLC
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 5920 VANDERCOOK ST
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City | MONROE
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State | MI
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Zip | 48161-3747
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Country | US
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Telephone | 734-790-1857
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Fax |
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Provider Business Mailing Address
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Address Line | 1416 S MAIN ST SUITE 220, #2029
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City | ADRIAN
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State | MI
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Zip | 49221
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Country | US
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Telephone | 734-790-1857
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Fax |
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Authorized Official
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Title or Position | ART THERAPIST, MANAGING MEMBER
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Name | AMBER JAMES
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Credential | ATR-BC
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Telephone | 734-790-1857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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