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General NPI Number Information
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NPI Number | 1891272159
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Entity Type | Organization
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Legal Business Name | STARR THERAPY SERVICES LLC
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 1749 HAMILTON RD STE 201B
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City | OKEMOS
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State | MI
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Zip | 48864-1941
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Country | US
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Telephone | 517-243-2047
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 337
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City | MASON
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State | MI
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Zip | 48854-0337
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Country | US
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Telephone | 517-676-9788
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | FRANK NEWSOME
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Credential |
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Telephone | 517-442-3341
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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 | 410100669
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License Number State | MI
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