Individual
MR. ANSEL FABIAN DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADDICTION THERAPIST
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201
(313) 576-1000
(313) 576-1091
Mailing address
5791 BALFOUR, DETROIT, MI 48224
(313) 576-1000
(313) 576-1091
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/05/2006
Last updated
07/08/2007
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