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General NPI Number Information
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NPI Number | 1578359428
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Entity Type | Organization
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Legal Business Name | WHOLE BODY LIBERATION COUNSELING LLC
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 2323 CANIFF ST
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City | HAMTRAMCK
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State | MI
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Zip | 48212-2946
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Country | US
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Telephone | 313-236-2425
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Fax |
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Provider Business Mailing Address
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Address Line | 2323 CANIFF ST
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City | HAMTRAMCK
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State | MI
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Zip | 48212-2946
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Country | US
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Telephone | 313-236-2425
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ANGELINE BOLTON
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Credential | LPC, ATR-BC
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Telephone | 313-236-2425
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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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