Organization
DREAM PROFESSIONAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN MICHELLE FOUCHE BRAZZLE M.D. (PRESIDENT)
(248) 932-0290
Entity
Organization
Contact information
Practice address
5640 W MAPLE RD, SUITE 310, WEST BLOOMFIELD, MI 48322-3716
(248) 932-0290
(248) 932-0358
Mailing address
5640 W MAPLE RD, SUITE 310, WEST BLOOMFIELD, MI 48322-3716
(248) 932-0290
(248) 932-0358
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
4301052026
MI
Other
Enumeration date
12/23/2010
Last updated
12/23/2010
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