Individual
MS. MARCIE E KANSOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
14203 PENROD ST, DETROIT, MI 48223-3578
(734) 972-6359
Mailing address
14203 PENROD ST, DETROIT, MI 48223-3578
(248) 289-3224
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401010715
MI
Other
Enumeration date
05/12/2011
Last updated
04/10/2025
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