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General NPI Number Information
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NPI Number | 1710452271
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Entity Type | Organization
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Legal Business Name | DOWNRIVER PROFESSIONAL COUNSELING, PLLC
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Dates
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Enumeration Date | 10/10/2018
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Last Update Date | 10/10/2018
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Provider Practice Location Address
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Address Line | 7000 ROOSEVELT AVE STE 203
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City | ALLEN PARK
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State | MI
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Zip | 48101-2583
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Country | US
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Telephone | 248-760-3125
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Fax |
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Provider Business Mailing Address
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Address Line | 7000 ROOSEVELT AVE STE 203
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City | ALLEN PARK
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State | MI
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Zip | 48101-2583
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Country | US
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Telephone | 248-760-3125
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH NOLAN
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Credential | LLMSW
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Telephone | 248-760-3125
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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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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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