| Ta Therapeutic Services, Llc | |
|
10936 Old State Rd Johannesburg MI 49751 | |
| (734) 755-3228 | |
| Not Available |
| Full Name | Ta Therapeutic Services, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 10936 Old State Rd, Johannesburg, Michigan |
| Authorized Official Name and Position | Traci A Doran (OWNER) |
| Authorized Official Contact | 7347553228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ta Therapeutic Services, Llc Po Box 196 Luzerne MI 48636-0196 Ph: () - | Ta Therapeutic Services, Llc 10936 Old State Rd Johannesburg MI 49751 Ph: (734) 755-3228 |
| NPI Number | 1598587966 |
|---|---|
| Provider Enumeration Date | 10/28/2024 |
| Last Update Date | 10/28/2024 |
| Certification Date | 10/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598587966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |