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Organization
ORCHID CORE VOC REHAB LLC
Active
Organization
ORCHID CORE VOC REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA LYNETTE WHITE MA, LPC, CRC, CBIS (OWNER/LICENSED PROFESSIONAL COUNSEL)
(313) 588-6671
Entity
Organization
Contact information
Practice address
16250 NORTHLAND DR STE 325, SOUTHFIELD, MI 48075-5219
(248) 841-0448
Mailing address
PO BOX 27716, DETROIT, MI 48227-0716
(313) 588-6671
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194250837
—
MI
Enumeration date
07/20/2020
Last updated
07/20/2020
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