Illumination Psychotherapy, Pllc | |
450 S Maple Rd Ste 858 Ann Arbor MI 48103-3835 | |
(773) 318-7304 | |
Not Available |
Full Name | Illumination Psychotherapy, Pllc |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 450 S Maple Rd Ste 858, Ann Arbor, Michigan |
Authorized Official Name and Position | Garrett Shotwell (OWNER) |
Authorized Official Contact | 7733187304 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Illumination Psychotherapy, Pllc 1715 Abbott Ave Ann Arbor MI 48103-4107 Ph: (773) 318-7304 | Illumination Psychotherapy, Pllc 450 S Maple Rd Ste 858 Ann Arbor MI 48103-3835 Ph: (773) 318-7304 |
NPI Number | 1245093590 |
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Provider Enumeration Date | 01/31/2024 |
Last Update Date | 02/15/2024 |
Certification Date | 02/15/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245093590 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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