Doctor Name: | MRS. ELIZABETH RACHAEL STARKWEATHER |
NPI Number: | 1417196999 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LLP |
License Number: | 6301013811 |
Business Practice Address: | 92 N Bridge St Saranac, MI - 488815102 |
Business Phone Number: | 6166426466 |
Business Fax Number: | |
Mailing Address: | 5819 Culpepper Ct, LOWELL |
State: | MI |
Postal Code: | 493318437 |
Phone Number: | 5174205627 |
Fax Number: | |
NPI Enumeration Date: | 02/06/2009 |
NPI Last Update Date: | 09/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | 6301013811 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |