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General NPI Number Information
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NPI Number | 1215671268
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Entity Type | Organization
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Legal Business Name | LIFESTYLE GUIDANCE CENTER LLC
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 53027 HAWALD DR
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-3757
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Country | US
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Telephone | 586-623-4160
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Fax | 586-623-4150
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Provider Business Mailing Address
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Address Line | 53027 HAWALD DR
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-3757
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Country | US
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Telephone | 586-623-4160
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Fax | 586-623-4150
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | EMILY BUDZYNOWSKI
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Credential |
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Telephone | 586-623-4160
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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 |
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License Number State |
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