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General NPI Number Information
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NPI Number | 1629563218
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Entity Type | Organization
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Legal Business Name | BALANCE LINK THERAPY GROUP PLLC
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 383 TILMOR DR
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City | WATERFORD
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State | MI
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Zip | 48328-2565
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Country | US
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Telephone | 248-842-4501
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Fax |
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Provider Business Mailing Address
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Address Line | 383 TILMOR DR
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City | WATERFORD
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State | MI
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Zip | 48328-2565
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Country | US
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Telephone | 248-842-4501
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Fax |
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Authorized Official
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Title or Position | FOUNDER/ THERAPIST
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Name | MS. CHRYSTAL N WESTBROOK
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Credential | MA LPC
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Telephone | 248-842-4501
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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 | 6401012818
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License Number State | MI
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