Individual
LAURIE CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
15000 GRATIOT AVE, DETROIT, MI 48205-1973
(313) 245-0649
Mailing address
5132 SYRACUSE ST, DEARBORN HEIGHTS, MI 48125-2139
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401015555
MI
101YP2500X
Professional Counselor
6401017188
MI
Other
Enumeration date
08/11/2017
Last updated
05/24/2024
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