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General NPI Number Information
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NPI Number | 1184378713
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Entity Type | Organization
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Legal Business Name | THE THERAPY COLLECTIVE OF MICHIGAN
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Dates
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Enumeration Date | 02/11/2022
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Last Update Date | 03/01/2025
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Provider Practice Location Address
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Address Line | 13330 FORT ST
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City | SOUTHGATE
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State | MI
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Zip | 48195-1137
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Country | US
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Telephone | 734-361-1416
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Fax |
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Provider Business Mailing Address
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Address Line | 13330 FORT ST
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City | SOUTHGATE
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State | MI
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Zip | 48195-1137
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Country | US
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Telephone | 734-361-1416
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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 | EMILY WEZNER-STEPANIAK
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Credential | LPC
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Telephone | 734-991-3965
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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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