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General NPI Number Information
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NPI Number | 1164956363
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Entity Type | Organization
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Legal Business Name | A MATTER OF LIVING
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 04/13/2017
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Provider Practice Location Address
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Address Line | 1009 MALTA ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-1926
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Country | US
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Telephone | 989-954-7076
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Fax |
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Provider Business Mailing Address
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Address Line | 1009 MALTA ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-1926
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Country | US
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Telephone | 989-954-7076
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | BRENDA SUE BENJAMIN
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Credential | LPC
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Telephone | 989-954-7076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401013338
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License Number State | MI
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