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General NPI Number Information
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NPI Number | 1841448628
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Entity Type | Organization
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Legal Business Name | A & A PSYCHOTHERAPY ASSOCIATES PC
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 4211 OKEMOS ROAD SUITE #1 A & A PSYCHOTHERAPY ASSOCIATES PC
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City | OKEMOS
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State | MI
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Zip | 48864-3287
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Country | US
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Telephone | 517-349-4111
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Fax | 517-347-6999
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Provider Business Mailing Address
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Address Line | PO BOX 564 A & A PSYCHOTHERAPY ASSOCIATES PC
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City | OKEMOS
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State | MI
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Zip | 48805-0564
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Country | US
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Telephone | 517-349-4111
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Fax | 517-347-6999
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Authorized Official
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Title or Position | PSYCHOTHERAPIST & PRESIDENT OF CORP
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Name | MR. JUAN JOSE ARELLANO LOPEZ
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Credential | MSW MA LMSW LMFT
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Telephone | 517-349-4111
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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 | 4101005356
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801016329
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License Number State | MI
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