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General NPI Number Information
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NPI Number | 1790550010
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Entity Type | Organization
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Legal Business Name | IRIS THERAPY PLLC
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Dates
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Enumeration Date | 11/16/2023
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 39111 6 MILE RD
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City | LIVONIA
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State | MI
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Zip | 48152-3926
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Country | US
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Telephone | 734-344-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 44607 FAIR OAKS DR
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City | CANTON
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State | MI
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Zip | 48187-2989
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Country | US
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Telephone | 734-344-2300
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | EMILY LUDWIG-CAREY
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Credential | LMSW-C
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Telephone | 734-344-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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