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General NPI Number Information
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NPI Number | 1376272484
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE POSITIVE CHOICES COUNSELING GROUP PLLC
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Dates
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Enumeration Date | 06/06/2022
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 12434 E 12 MILE RD
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City | WARREN
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State | MI
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Zip | 48093-3536
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Country | US
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Telephone | 586-806-6195
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Fax |
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Provider Business Mailing Address
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Address Line | 12434 E 12 MILE RD
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City | WARREN
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State | MI
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Zip | 48093-3536
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Country | US
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Telephone | 586-806-6195
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Fax |
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Authorized Official
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Title or Position | LICENSED
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Name | MARQUISE HARRIS
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Credential | LPC
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Telephone | 586-806-6195
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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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