Individual
HEATHER L WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC
Contact information
Practice address
16001 W 9 MILE RD, PROVIDENCE HOSPITAL, SOUTHFIELD, MI 48075-4818
(248) 849-2096
Mailing address
22195 WESTHAMPTON ST, OAK PARK, MI 48237-3805
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401008989
MI
Other
Enumeration date
11/01/2012
Last updated
01/08/2025
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