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General NPI Number Information
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NPI Number | 1790484962
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Entity Type | Organization
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Legal Business Name | EMBODIED BREATH COUNSELING
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 210 W UNIVERSITY DR
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City | ROCHESTER
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State | MI
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Zip | 48307-1976
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Country | US
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Telephone | 248-266-1560
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Fax |
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Provider Business Mailing Address
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Address Line | 888 PEACH BLOSSOM LN
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City | ROCHESTER HILLS
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State | MI
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Zip | 48306-3347
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Country | US
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Telephone | 586-904-1449
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MARCI NOWACZOK
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Credential | LPC
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Telephone | 586-904-1449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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