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General NPI Number Information
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NPI Number | 1467831503
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Entity Type | Organization
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Legal Business Name | AGAPE FAMILY COUNSELING, PLLC
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Dates
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Enumeration Date | 05/21/2015
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Last Update Date | 05/21/2015
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Provider Practice Location Address
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Address Line | 1460 WALTON BLVD SUITE 218
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-1768
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Country | US
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Telephone | 248-568-3125
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Fax | 248-608-6800
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Provider Business Mailing Address
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Address Line | 1460 WALTON BLVD SUITE 218
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-1768
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Country | US
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Telephone | 248-568-3125
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Fax | 248-608-6800
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. WENDY ESSENBURG
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Credential | PH,D.
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Telephone | 248-568-3125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6301012902
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License Number State | MI
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