Individual
PHYLLIS E KEARNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Contact information
Practice address
4777 E OUTER DR, DETROIT, MI 48234-3241
(313) 369-5000
(313) 369-5545
Mailing address
28000 DEQUINDRE RD, WARREN, MI 48092-2468
(586) 753-0405
(586) 753-0404
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401010774
MI
104100000X
Social Worker
6802011985
MI
Other
Enumeration date
09/12/2008
Last updated
09/12/2008
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