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General NPI Number Information
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NPI Number | 1457141079
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Entity Type | Organization
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Legal Business Name | LJR WELLNESS CONSULTING SERVICES
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 600 E BROADWAY ST STE 207
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City | MT PLEASANT
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State | MI
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Zip | 48858-2776
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Country | US
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Telephone | 231-846-8825
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Fax | 231-846-8825
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Provider Business Mailing Address
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Address Line | 600 E BROADWAY ST STE 207
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City | MT PLEASANT
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State | MI
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Zip | 48858-2776
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Country | US
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Telephone | 231-846-8825
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Fax | 231-846-8825
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | LEAH JEAN RUTKOWSKI
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Credential | LPC, NCC
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Telephone | 231-248-8825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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