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Individual

ALLEN RUSSELL ADAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
17352 W 12 MILE RD, SUITE 100, SOUTHFIELD, MI 48076-2119
(248) 559-0730
(248) 569-7626
Mailing address
18876 SAINT AUBIN ST, DETROIT, MI 48234-1221
(313) 402-7779
(248) 569-7626

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801088547
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6801088547
STATE OF MICHIGAN
MI
Enumeration date
05/30/2008
Last updated
05/30/2008
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