Basic Information
| Provider Information | |||||||||
| NPI: | 1215370259 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MESSINA | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | HELENE | ||||||||
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| Credential: | LLMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7647 WEBER RD | ||||||||
| Address2: | |||||||||
| City: | SALINE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481769207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342727517 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2280 E GRAND RIVER AVE | ||||||||
| Address2: | |||||||||
| City: | HOWELL | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488438503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5175464126 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2013 | ||||||||
| LastUpdateDate: | 10/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | 6801103051 | MI | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.