Individual
LAVERNE DENISE MCGLOTHIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAC
Contact information
Practice address
5555 CONNER ST, 2000 NORTH, DETROIT, MI 48213-3448
(313) 921-8102
(313) 921-8148
Mailing address
488 FRAZIER ST, RIVER ROUGE, MI 48218-1025
(313) 415-7222
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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