| Wellness Therapy Center Llc | |
|
685 N Beck Rd Canton MI 48187-4808 | |
| (313) 658-0388 | |
| Not Available |
| Full Name | Wellness Therapy Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 685 N Beck Rd, Canton, Michigan |
| Authorized Official Name and Position | Nagham Razaq Alkhafaji (MAIN PROVIDER) |
| Authorized Official Contact | 3136580388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Therapy Center Llc 685 N Beck Rd Canton MI 48187-4808 Ph: (313) 658-0388 | Wellness Therapy Center Llc 685 N Beck Rd Canton MI 48187-4808 Ph: (313) 658-0388 |
| NPI Number | 1184398430 |
|---|---|
| Provider Enumeration Date | 08/02/2021 |
| Last Update Date | 08/02/2021 |
| Certification Date | 08/02/2021 |
| Medicare PECOS PAC ID | 0941738140 |
|---|---|
| Medicare Enrollment ID | O20250116000517 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184398430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Amanda Osorio-cooksy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134337595 PECOS PAC ID: 2163859059 Enrollment ID: I20250203002383 |
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