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General NPI Number Information
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NPI Number | 1598239733
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Entity Type | Organization
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Legal Business Name | THE ANXIETY RECOVERY CENTER PLLC
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Dates
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Enumeration Date | 01/21/2019
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Last Update Date | 01/21/2019
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Provider Practice Location Address
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Address Line | 7000 ROOSEVELT AVE STE 101
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City | ALLEN PARK
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State | MI
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Zip | 48101-2583
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Country | US
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Telephone | 517-719-5813
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Fax |
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Provider Business Mailing Address
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Address Line | 7887 BREEZEWOOD CT
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City | YPSILANTI
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State | MI
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Zip | 48197-6208
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Country | US
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Telephone | 517-719-5813
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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 | KELLY INFANTE
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Credential | MA, LLP
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Telephone | 517-719-5813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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