Individual
TAMMY LATICE TERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2925 RUSSELL ST, DETROIT, MI 48207-4825
(734) 999-2150
Mailing address
2925 RUSSELL ST, DETROIT, MI 48207-4825
(734) 999-2150
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6851110472
MI
101YM0800X
Mental Health Counselor
6851110472
—
1041C0700X
Clinical Social Worker
6801110472
MI
Other
Enumeration date
07/07/2021
Last updated
10/03/2024
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