Individual
MRS. CARLLOTTA BOHANEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
24424 W 6 MILE RD, DETROIT, MI 48219-3653
(313) 531-2500
Mailing address
29600 PICKFORD ST, LIVONIA, MI 48152-3464
(313) 570-9416
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4704275160
MI
Other
Enumeration date
01/20/2015
Last updated
01/20/2015
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