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Organization
SUPREME LIFE WELLNESS PLLC
Active
Organization
SUPREME LIFE WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA TRAPP LCSW (OWNER)
(313) 522-4708
Entity
Organization
Contact information
Practice address
16970 NEW HAMPSHIRE DR, SOUTHFIELD, MI 48075-2905
(313) 522-4708
Mailing address
16970 NEW HAMPSHIRE DR, SOUTHFIELD, MI 48075-2905
(313) 522-4708
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/22/2023
Last updated
10/12/2023
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