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General NPI Number Information
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NPI Number | 1184807299
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE EDUCATIONAL PARTNERS, LLC
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 6739 COURTLAND DR NE SUITE 101
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City | ROCKFORD
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State | MI
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Zip | 49341-7216
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Country | US
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Telephone | 616-874-7490
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Fax | 847-770-4772
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Provider Business Mailing Address
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Address Line | 6739 COURTLAND DR NE SUITE 101
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City | ROCKFORD
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State | MI
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Zip | 49341-7216
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Country | US
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Telephone | 616-874-7490
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Fax | 847-770-4772
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Authorized Official
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Title or Position | OWNER
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Name | JULIE ANN BILLETT
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Credential | NP
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Telephone | 616-874-7490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State | MI
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