Individual
ANN GOURLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1225 E BIG BEAVER RD, TROY, MI 48083-1905
(248) 524-8801
(248) 524-8850
Mailing address
1162 VINEWOOD ST, APT.1, DETROIT, MI 48216-2230
(313) 920-9683
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802082866
MI
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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