Organization
DELAWARE PROFESSIONAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BOYD KRISEL JR. MSW (OWNER)
(313) 421-8366
Entity
Organization
Contact information
Practice address
116 W 8 MILE RD STE B, HAZEL PARK, MI 48030-2433
(313) 421-8366
Mailing address
116 W 8 MILE RD STE B, HAZEL PARK, MI 48030-2433
(313) 421-8366
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801059788
MI
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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