BY MOONLIGHT AND TIDE PSYCHOTHERAPY PLLC

OKEMOS, MI
NPI1912798174
Entity TypeOrganization
Authorized ContactCASSIANN M PROCENKO
Clinical Director
320-310-8895
Organization Subpart ?No
Primary Taxonomy261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date2025-05-15
Last Update Date2025-05-15
Business Address
BY MOONLIGHT AND TIDE PSYCHOTHERAPY PLLC
2222 W GRAND RIVER AVE STE A
OKEMOS, MI 48864-1604
Phone number: 248-266-0625
Mailing Address
BY MOONLIGHT AND TIDE PSYCHOTHERAPY PLLC
740 KIMBERLY APT 302
LAKE ORION, MI 48362-2963
Phone number: 320-310-8895