# THE CHILDREN'S CENTER OF WAYNE CO., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023736212
- **Authorized official:** TIFFANY LEID (DIRECTOR OF REVENUE CYCLE)
- **Authorized official phone:** (313) 262-0951

## Contact information

- **Practice address:** 79 W ALEXANDRINE ST, DETROIT, MI 48201-2015
- **Practice address phone:** (313) 262-0951
- **Mailing address:** 79 W ALEXANDRINE ST, DETROIT, MI 48201-2015
- **Mailing address phone:** (313) 262-0951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 08/15/2022
- **Last updated:** 08/15/2022