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General NPI Number Information
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NPI Number | 1184393811
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Entity Type | Organization
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Legal Business Name | MCCRANDALL THERAPY SERVICES LLC
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 2394 WILLOWDALE DR
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City | BURTON
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State | MI
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Zip | 48509-4850
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Country | US
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Telephone | 810-373-2867
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Fax |
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Provider Business Mailing Address
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Address Line | 12745 S SAGINAW ST, STE 806 #110
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City | GRAND BLANC
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State | MI
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Zip | 48439
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Country | US
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Telephone | 810-373-2867
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | EMILY MCCRANDALL
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Credential | LMSW
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Telephone | 810-373-2867
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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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