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Michael Acosta

NPI Registration Record

Provider / OrganizationNPIDate Certified
MICHAEL ACOSTA15084604602020-11-22
Entity TypeIndividual
Provider Name Michael Acosta LMSW
Practice Office Address1011 LAKE RIDGE DR UNIT 305
TRAVERSE CITY, MI US
Practice Office Telephone2315900048
Mailing Address1011 LAKE RIDGE DR UNIT 305
TRAVERSE CITY, MI 496846625 US
Business Telephone2315900048
HPT Codes
CodeLicense NoState
1041C0700X PRIMARY6801064319 MI
OPI Codes

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