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Organization
ST JUDE THERAPY CENTER STAFFING
Active
Organization
ST JUDE THERAPY CENTER STAFFING
Active
Other names
St Jude Psychiatric and Therapy Center
Organization subpart
No
Provider details
NPI number
Authorized official
JUDE OSAGIE UKPEBOR NP (PMHNP-BC)
(313) 681-2209
Entity
Organization
Contact information
Practice address
27200 LAHSER RD STE 100, SOUTHFIELD, MI 48034-2137
(313) 681-2209
Mailing address
27200 LAHSER RD STE 100, SOUTHFIELD, MI 48034-2137
(313) 681-2209
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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