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General NPI Number Information
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NPI Number | 1831523240
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Entity Type | Organization
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Legal Business Name | SOUL PURPOSE COUNSELING & CONSULTATION, PLLC
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Dates
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Enumeration Date | 08/22/2013
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Last Update Date | 08/22/2013
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Provider Practice Location Address
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Address Line | 912 TIMBERLINE TRL
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City | GAYLORD
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State | MI
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Zip | 49735-9316
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Country | US
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Telephone | 989-614-7080
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Fax |
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Provider Business Mailing Address
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Address Line | 912 TIMBERLINE TRL
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City | GAYLORD
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State | MI
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Zip | 49735-9316
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Country | US
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Telephone | 989-614-7080
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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 | ASHLEY B HINTON
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Credential | MA, LLPC, NCC
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Telephone | 989-614-7080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6401013682
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License Number State | MI
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