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General NPI Number Information
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NPI Number | 1740041680
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Entity Type | Organization
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Legal Business Name | NEW PINE THERAPY PLLC
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 7854 DRAKESHIRE BLVD
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City | ALMONT
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State | MI
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Zip | 48003-8796
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Country | US
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Telephone | 586-460-4042
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Fax |
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Provider Business Mailing Address
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Address Line | 2222 W GRAND RIVER AVE STE A
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City | OKEMOS
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State | MI
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Zip | 48864-1604
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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 | OWNER
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Name | ROSALIE PHILLIPS
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Credential | LMFT
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Telephone | 425-345-4811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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