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General NPI Number Information
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NPI Number | 1760856900
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Entity Type | Organization
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Legal Business Name | NAVIGATING LIFE
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Dates
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Enumeration Date | 11/28/2015
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Last Update Date | 11/28/2015
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Provider Practice Location Address
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Address Line | 48449 BEAVER CREEK DR
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City | PLYMOUTH
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State | MI
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Zip | 48170-3373
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Country | US
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Telephone | 313-570-9352
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Fax |
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Provider Business Mailing Address
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Address Line | 48449 BEAVER CREEK DR
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City | PLYMOUTH
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State | MI
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Zip | 48170-3373
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Country | US
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Telephone | 313-570-9352
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. LAURA DYAS
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Credential | LBSW,LPC,MA
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Telephone | 313-570-9352
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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 | 6401013818
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License Number State | MI
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