Individual
PATRICIA TENNYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 STODDARD RD, RICHMOND, MI 48062-2505
(810) 392-2167
Mailing address
42567 SHERIDAN DR, CLINTON TWP, MI 48038-6436
(586) 612-5362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
MI
Enumeration date
06/11/2019
Last updated
06/11/2019
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