Provider Demographics
NPI:1447504071
Name:TREE OF LIFE COUNSELING SERVICES PLLC
Entity type:Organization
Organization Name:TREE OF LIFE COUNSELING SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MA LPC
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUMLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:734-915-6722
Mailing Address - Street 1:3826 MCNEIL DRVIE
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49270-9759
Mailing Address - Country:US
Mailing Address - Phone:734-915-6722
Mailing Address - Fax:
Practice Address - Street 1:3554 S CUSTER RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-9774
Practice Address - Country:US
Practice Address - Phone:734-915-6722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007774101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty