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General NPI Number Information
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NPI Number | 1699594549
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Entity Type | Organization
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Legal Business Name | WOVEN PATH ART THERAPY AND COUNSELING LLC
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 308 CLEVELAND AVE STE 209
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City | ISHPEMING
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State | MI
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Zip | 49849-1849
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Country | US
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Telephone | 906-262-0247
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Fax |
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Provider Business Mailing Address
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Address Line | 624 IRON ST
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City | ISHPEMING
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State | MI
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Zip | 49849-1152
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | AMY RYNN
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Credential |
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Telephone | 906-262-0247
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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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