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1023380276
MICHAEL IMBURGIA
PORTAGE, IN
NPI
1023380276
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2012-02-03
Last Update Date
2012-02-03
Business Address
-- MICHAEL IMBURGIA BA
3176 LANCER ST
PORTAGE, IN 46368-4408
Phone number: 219-762-9557
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Mailing Address
-- MICHAEL IMBURGIA BA
2963 JOANN ST
PORTAGE, IN 46368-3927
Phone number:
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