Individual
BRANDY SPRING PASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA. MFT
Contact information
Practice address
882 OAKMAN BLVD, DETROIT, MI 48238-3710
(313) 961-4890
Mailing address
882 OAKMAN BLVD, DETROIT, MI 48238-3710
(313) 961-4890
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4101007284
MI
Other
Enumeration date
12/10/2008
Last updated
03/04/2024
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