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General NPI Number Information
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NPI Number | 1316633639
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Entity Type | Individual
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Provider Name | AMANDA RENEE BISHOP LLPC
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Gender | Female
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Dates
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Enumeration Date | 04/12/2023
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 5397 MILLINGTON RD
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City | MILLINGTON
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State | MI
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Zip | 48746-8701
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Country | US
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Telephone | 989-871-6695
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Fax |
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Provider Business Mailing Address
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Address Line | 10436 FARRAND RD # 10436
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City | OTISVILLE
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State | MI
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Zip | 48463-9771
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Country | US
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Telephone | 989-545-2165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6451014920
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License Number State | MI
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