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Organization
DETROIT WAYNE MENTAL HEALTH AUTHORITY
Active
Organization
DETROIT WAYNE MENTAL HEALTH AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACIE DURANT CPA (CHIEF FINANCIAL OFFICER)
(313) 344-9099
Entity
Organization
Contact information
Practice address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 344-9099
Mailing address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 344-9090
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
103TF0000X
Family Psychologist
—
NULL
103TF0000X
Family Psychologist
—
—
Other
Enumeration date
02/14/2014
Last updated
10/24/2016
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