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Organization
DEBRA MARY GREGORY PC LLC
Active
Organization
DEBRA MARY GREGORY PC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA MARY GREGORY LCSW (CLINICAL SOCIAL WORKER)
(248) 568-1344
Entity
Organization
Contact information
Practice address
7130 WALNUT LAKE ROAD, WEST BLOOMFIELD, MI 48323
(248) 568-1344
(248) 922-9040
Mailing address
5639 SASHABAW RD, CLARKSTON, MI 48346-3149
(248) 568-1344
(248) 922-9040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801033761
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8008965160
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/14/2010
Last updated
10/14/2010
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