| Doctor Name: | MR. BRUCE ALBERT HEUSTIS |
| NPI Number: | 1215177613 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 6401009464 |
| Business Practice Address: | 11017 Herring St Marcellus, MI - 490679412 |
| Business Phone Number: | 2692445818 |
| Business Fax Number: | 2694926088 |
| Mailing Address: | 11017 Herring St, MARCELLUS |
| State: | MI |
| Postal Code: | 490679412 |
| Phone Number: | 2692445818 |
| Fax Number: | 2694926088 |
| NPI Enumeration Date: | 02/24/2009 |
| NPI Last Update Date: | 02/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401009464 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |