Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 6801078975 | MI |
NPI | 1003022914 |
---|---|
Provider Name | Ms. Theresa Louise Britton |
First Address | Portage, MI 49024-8040 |
Second Address | Benton Harbor, MI 49022-5065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |