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General NPI Number Information
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NPI Number | 1700100989
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Entity Type | Organization
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Legal Business Name | WHOLE LIFE COUNSELING PLLC
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 1011 W MAPLE ST STE 400
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City | KALAMAZOO
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State | MI
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Zip | 49008-5806
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Country | US
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Telephone | 269-353-7607
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Fax | 269-888-2260
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Provider Business Mailing Address
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Address Line | 1011 W MAPLE ST STE 400
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City | KALAMAZOO
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State | MI
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Zip | 49008-5806
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Country | US
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Telephone | 269-353-7607
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Fax | 269-888-2260
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Authorized Official
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Title or Position | DIRECTOR
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Name | SUSAN RAE HALL
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Credential |
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Telephone | 269-345-5776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | .6401005003
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License Number State | MI
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