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General NPI Number Information
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NPI Number | 1609283266
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Entity Type | Organization
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Legal Business Name | THYRAPIE, LLC
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Dates
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Enumeration Date | 07/16/2014
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Last Update Date | 12/15/2015
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Provider Practice Location Address
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Address Line | 710 CHIPPEWA SQ SUITE 208
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City | MARQUETTE
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State | MI
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Zip | 49855-4821
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Country | US
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Telephone | 906-362-1647
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Fax |
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Provider Business Mailing Address
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Address Line | 102 W WASHINGTON ST SUITE 114
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City | MARQUETTE
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State | MI
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Zip | 49855-4368
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Country | US
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Telephone | 906-362-1647
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MARY C RITTER
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Credential | LPC
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Telephone | 906-362-1647
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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 | 6401002600
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License Number State | MI
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