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General NPI Number Information
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NPI Number | 1881115079
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Entity Type | Individual
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Provider Name | HAILI GABRIS MA LPC
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Gender | Female
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 524 E MILHAM AVE STE B
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City | PORTAGE
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State | MI
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Zip | 49002-1473
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Country | US
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Telephone | 269-264-5053
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Fax | 616-552-1619
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Provider Business Mailing Address
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Address Line | 5757 ROCKY RD
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City | KALAMAZOO
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State | MI
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Zip | 49004-9173
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6401018971
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License Number State | MI
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