| Horse Play, Llc | |
|
2820 Niles Rd Saint Joseph MI 49085-3338 | |
| (269) 405-0653 | |
| Not Available |
| Full Name | Horse Play, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2820 Niles Rd, Saint Joseph, Michigan |
| Authorized Official Name and Position | Kristine Proctor (OWNER) |
| Authorized Official Contact | 2694050653 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Horse Play, Llc 2820 Niles Rd Saint Joseph MI 49085-3338 Ph: (269) 405-0653 | Horse Play, Llc 2820 Niles Rd Saint Joseph MI 49085-3338 Ph: (269) 405-0653 |
| NPI Number | 1437464229 |
|---|---|
| Provider Enumeration Date | 08/17/2010 |
| Last Update Date | 08/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437464229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301013553 (Michigan) | Primary |
| 1041C0700X | Social Worker - Clinical | 6801069783 (Michigan) | Secondary |
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