Individual
REGINA BOMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23640 OAK GLEN DR, SOUTHFIELD, MI 48033-3497
(248) 479-1007
Mailing address
23640 OAK GLEN DR, SOUTHFIELD, MI 48033-3497
(248) 479-1007
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401007471
MI
Other
Enumeration date
10/15/2007
Last updated
10/15/2007
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