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General NPI Number Information
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NPI Number | 1922629047
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL CENTER FOR INTEGRAL HEALTH AND EDUCATION
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 263 MIDTOWN DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-5752
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Country | US
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Telephone | 231-642-9033
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Fax | 231-642-9058
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Provider Business Mailing Address
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Address Line | 263 MIDTOWN DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-5752
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Country | US
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Telephone | 231-642-9033
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Fax | 231-642-9058
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DR. ELIZABETH MARIE TEKLINSKI
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Credential | PHD, LPC, NCC, BC-H
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Telephone | 800-659-1381
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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 |
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License Number State |
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