| Illuminate Therapy Llc | |
|
234 W Caroline St Ste 3 Fenton MI 48430-2807 | |
| (517) 974-9353 | |
| Not Available |
| Full Name | Illuminate Therapy Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 234 W Caroline St Ste 3, Fenton, Michigan |
| Authorized Official Name and Position | Amy Thompson (OWNER) |
| Authorized Official Contact | 5179749353 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminate Therapy Llc 234 W Caroline St Ste 3 Fenton MI 48430-2807 Ph: () - | Illuminate Therapy Llc 234 W Caroline St Ste 3 Fenton MI 48430-2807 Ph: (517) 974-9353 |
| NPI Number | 1194367953 |
|---|---|
| Provider Enumeration Date | 10/14/2019 |
| Last Update Date | 10/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194367953 | NPI | - | NPPES |
| 1306242623 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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