Organization
MHSDD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLIN KEITH LEPARD MD (MANAGER)
(248) 543-8070
Entity
Organization
Contact information
Practice address
33000 ANNAPOLIS ST, SUITE 150, WAYNE, MI 48184-2917
(734) 728-3446
(734) 728-4893
Mailing address
PO BOX 44047, DETROIT, MI 48244-0047
(248) 543-8070
(248) 543-9005
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
03/28/2008
Last updated
04/01/2009
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