Organization
LAKESHORE COMMUNITY COUNSELING CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG ALLEN DERROR PHD (EXECUTIVE DIRECTOR)
(231) 878-3059
Entity
Organization
Contact information
Practice address
9116 E 13TH ST, SUITE B, CADILLAC, MI 49601-8126
(231) 878-3059
Mailing address
9116 E 13TH ST, SUITE B, CADILLAC, MI 49601-8126
(231) 878-3059
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6301013463
MI
Other
Enumeration date
01/29/2013
Last updated
01/29/2013
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