Individual
MS. DENEQUA GULLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PEER SPECIALIST
Contact information
Practice address
300 W MCNICHOLS RD, DETROIT, MI 48203-2703
(313) 867-8015
(313) 867-8040
Mailing address
300 W MCNICHOLS RD, DETROIT, MI 48203-2703
(313) 867-8015
(313) 867-8040
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
143236940
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437236940
—
MI
Enumeration date
11/01/2011
Last updated
11/01/2011
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