Individual
ABBOTT DAIMLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
611 NORRIS ST, YPSILANTI, MI 48198-2823
(734) 219-9160
Mailing address
611 NORRIS ST, YPSILANTI, MI 48198-2823
(734) 219-9160
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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