Provider Demographics
NPI:1174065205
Name:OKEMOS THERAPY ASSOCIATES
Entity type:Organization
Organization Name:OKEMOS THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/HEAD THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:K
Authorized Official - Last Name:ZOUAOUI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:517-281-0644
Mailing Address - Street 1:2160 HAMILTON RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-1774
Mailing Address - Country:US
Mailing Address - Phone:517-281-0644
Mailing Address - Fax:
Practice Address - Street 1:2160 HAMILTON RD
Practice Address - Street 2:SUITE C
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1774
Practice Address - Country:US
Practice Address - Phone:517-281-0644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007673101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty