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General NPI Number Information
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NPI Number | 1679051973
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Entity Type | Organization
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Legal Business Name | REBECCA SPANN, ED.S, NCC, LPC -LLC
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 07/30/2018
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Provider Practice Location Address
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Address Line | 8650 BYRON CENTER AVE SW STE 13
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City | BYRON CENTER
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State | MI
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Zip | 49315-9589
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Country | US
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Telephone | 616-259-6266
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Fax |
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Provider Business Mailing Address
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Address Line | 8650 BYRON CENTER AVE SW STE 13
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City | BYRON CENTER
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State | MI
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Zip | 49315-9589
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Country | US
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Telephone | 616-259-6266
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Fax |
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Authorized Official
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Title or Position | OWNER- LICENSED PROFESSIONAL COUNSE
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Name | REBECCA RENEE SPANN
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Credential | ED.S, NCC, LPC
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Telephone | 616-259-6266
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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 | 6401016033
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License Number State | MI
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