| Holistic Drama Llc | |
|
340 N Main St Ste 201 Plymouth MI 48170-1290 | |
| (734) 748-3140 | |
| Not Available |
| Full Name | Holistic Drama Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 340 N Main St Ste 201, Plymouth, Michigan |
| Authorized Official Name and Position | Jenelle Mazaris (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7347483140 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistic Drama Llc 15535 Northville Forest Dr Apt 251u Plymouth MI 48170-4947 Ph: (734) 748-3307 | Holistic Drama Llc 340 N Main St Ste 201 Plymouth MI 48170-1290 Ph: (734) 748-3140 |
| NPI Number | 1700380664 |
|---|---|
| Provider Enumeration Date | 03/23/2018 |
| Last Update Date | 03/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700380664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 4101006577 (Michigan) | Primary |
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