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Individual

LARRY HATHORNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2000 TOWN CTR, 1900, SOUTHFIELD, MI 48075-1135
(313) 701-5787
Mailing address
8326 ESPER ST, DETROIT, MI 48204-3122
(313) 701-5787

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
L749595
MI

Other

Enumeration date
08/18/2015
Last updated
08/18/2015
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