| Willow Mental Wellness | |
|
513 Detroit Ave Royal Oak MI 48073-3692 | |
| (313) 418-0273 | |
| Not Available |
| Full Name | Willow Mental Wellness |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 513 Detroit Ave, Royal Oak, Michigan |
| Authorized Official Name and Position | Corey Lariscy (OWNER) |
| Authorized Official Contact | 3134180273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Mental Wellness 513 Detroit Ave Royal Oak MI 48073-3692 Ph: (313) 418-0273 | Willow Mental Wellness 513 Detroit Ave Royal Oak MI 48073-3692 Ph: (313) 418-0273 |
| NPI Number | 1144000753 |
|---|---|
| Provider Enumeration Date | 10/02/2023 |
| Last Update Date | 10/02/2023 |
| Certification Date | 10/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144000753 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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