Individual
CARRIE LYNN LAURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLMSW, CAADC-DP
Contact information
Practice address
6309 MACK AVE STE 100, DETROIT, MI 48207-2302
(313) 396-5300
(313) 396-5353
Mailing address
14796 SHENANDOAH DR BLDG 24, RIVERVIEW, MI 48193-7731
(734) 925-2016
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801110369
MI
Other
Enumeration date
09/04/2018
Last updated
09/23/2021
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