Individual
MRS. ELIZABETH BALTAZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A
Contact information
Practice address
20303 KELLY RD, DETROIT, MI 48225-1206
(313) 400-9613
Mailing address
532 ROBERT JOHN RD, GROSSE POINTE WOODS, MI 48236-4101
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401012989
MI
Other
Enumeration date
08/05/2013
Last updated
09/19/2014
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