Individual
TERRY BETHEL TROUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
17352 W 12 MILE RD, SUITE 100, SOUTHFIELD, MI 48076-2119
(248) 559-0730
Mailing address
18691 LITTLEFIELD ST, DETROIT, MI 48235-1352
(363) 433-6263
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401008287
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401008287
STATE LICENSE NUMBER
MI
Enumeration date
04/13/2011
Last updated
04/13/2011
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