Individual
MRS. LORA DIANE MAXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
79 W ALEXANDRINE ST, DETROIT, MI 48201-2015
(313) 221-1438
Mailing address
24138 PENNIE ST, DEARBORN HEIGHTS, MI 48125-1552
(313) 530-3976
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401011557
MI
Other
Enumeration date
04/22/2011
Last updated
09/07/2016
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