| Intentional Wellbeing Llc | |
|
1122 N. Leroy Rd Suite A Fenton MI 48430 | |
| (810) 373-5591 | |
| Not Available |
| Full Name | Intentional Wellbeing Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1122 N. Leroy Rd, Fenton, Michigan |
| Authorized Official Name and Position | Cristina Leclair (OWNER) |
| Authorized Official Contact | 8103735591 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intentional Wellbeing Llc 1122 N. Leroy Rd Suite A Fenton MI 48430 Ph: (810) 373-5591 | Intentional Wellbeing Llc 1122 N. Leroy Rd Suite A Fenton MI 48430 Ph: (810) 373-5591 |
| NPI Number | 1366994410 |
|---|---|
| Provider Enumeration Date | 10/25/2016 |
| Last Update Date | 09/25/2020 |
| Certification Date | 09/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366994410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301015165 (Michigan) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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