Individual
MRS. SUNDRA KOLLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
13220 WOODWARD AVE, HIGHLAND PARK, MI 48203-3610
(313) 868-1946
Mailing address
12722 WOODMONT AVE, DETROIT, MI 48227-1290
(313) 653-0344
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1-02360
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3022440
—
MI
Enumeration date
03/20/2007
Last updated
07/09/2007
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