PROVISIONAL THERAPY ASSOCIATES

WEST BLOOMFIELD, MI
NPI1831943026
Entity TypeOrganization
Authorized ContactLINA MARI ESCAMILLA
Group Representative
248-240-2963
Organization Subpart ?No
Primary Taxonomy101YP2500X Counselor, Professional
Enumeration Date2024-04-15
Last Update Date2024-04-15
Business Address
PROVISIONAL THERAPY ASSOCIATES
4241 BRECKENRIDGE DR
WEST BLOOMFIELD, MI 48322-4430
Phone number: 248-240-2963
Mailing Address
PROVISIONAL THERAPY ASSOCIATES
4241 BRECKENRIDGE DR
WEST BLOOMFIELD, MI 48322-4430
Phone number: 248-240-2963
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