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711 West Thirteen Mile Rd Betty Thack Ma Lpc Madison Heights MI 48071 | |
| (248) 761-9771 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 711 West Thirteen Mile Rd, Madison Heights, Michigan |
| Authorized Official Name and Position | Betty Jane Thack (COUNSELOR/PSYCHOTHERAPIST) |
| Authorized Official Contact | 2487619771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
711 West Thirteen Mile Rd Betty Thack Ma Lpc Madison Heights MI 48071 Ph: (248) 761-9771 | 711 West Thirteen Mile Rd Betty Thack Ma Lpc Madison Heights MI 48071 Ph: (248) 761-9771 |
| NPI Number | 1235594284 |
|---|---|
| Provider Enumeration Date | 12/17/2015 |
| Last Update Date | 01/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235594284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6401009796 (Michigan) | Primary |
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