| Luminous Path Therapy | |
|
8415 Shirley Ct Apt 11 Portage MI 49024-4764 | |
| (269) 245-9455 | |
| Not Available |
| Full Name | Luminous Path Therapy |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8415 Shirley Ct Apt 11, Portage, Michigan |
| Authorized Official Name and Position | Travis Guerrero (THERAPIST/OWNER) |
| Authorized Official Contact | 2692459455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luminous Path Therapy 8415 Shirley Ct Apt 11 Portage MI 49024-4764 Ph: (269) 245-9455 | Luminous Path Therapy 8415 Shirley Ct Apt 11 Portage MI 49024-4764 Ph: (269) 245-9455 |
| NPI Number | 1902655178 |
|---|---|
| Provider Enumeration Date | 05/18/2024 |
| Last Update Date | 05/22/2024 |
| Certification Date | 05/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902655178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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