Individual
LAVIESTA FERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3031 W GRAND BLVD, SUITE 450, DETROIT, MI 48202-3046
(313) 346-5235
Mailing address
3031 W GRAND BLVD, SUITE 450, DETROIT, MI 48202-3046
(313) 346-5235
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
27159
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2014
Last updated
02/25/2021
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