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General NPI Number Information
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NPI Number | 1265914832
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Entity Type | Organization
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Legal Business Name | ASPIRE CONSULTATION LLC
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 124 PEARL ST STE 401
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City | YPSILANTI
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State | MI
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Zip | 48197-2663
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Country | US
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Telephone | 734-276-6661
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Fax |
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Provider Business Mailing Address
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Address Line | 4742 BRIDLE RUN APT 2C
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City | YPSILANTI
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State | MI
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Zip | 48197-9130
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Country | US
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Telephone | 734-276-6661
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | KIYANA HORTON
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Credential | LMSW
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Telephone | 734-276-6661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801093883
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License Number State | MI
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