Individual
KELSEY ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12501 HAMILTON AVE, DETROIT, MI 48203-3243
(313) 865-1580
Mailing address
12501 HAMILTON AVE, DETROIT, MI 48203-3243
(313) 865-1580
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912062068
—
MI
Enumeration date
11/28/2016
Last updated
11/28/2016
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