Provider Demographics
NPI:1841590775
Name:CIRNER, THERESE (LPC)
Entity type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:CIRNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 HOGBACK RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9749
Mailing Address - Country:US
Mailing Address - Phone:734-477-9020
Mailing Address - Fax:734-477-9022
Practice Address - Street 1:2010 HOGBACK RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9749
Practice Address - Country:US
Practice Address - Phone:734-477-9020
Practice Address - Fax:734-477-9022
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1630075101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional