Individual
MS. LISA ELIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
12200 E 13 MILE RD, WARREN, MI 48093-3093
(814) 392-2248
(586) 353-0530
Mailing address
79 W ALEXANDRINE ST, DETROIT, MI 48201-2015
(313) 831-5535
(313) 831-2608
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401015067
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235525205
—
MI
Enumeration date
04/07/2015
Last updated
07/21/2022
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