Individual
CAROL ANN MARINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17348 W 12 MILE RD STE 106, SOUTHFIELD, MI 48076-6325
(888) 492-9386
Mailing address
PO BOX 760224, LATHRUP VILLAGE, MI 48076-0224
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401002893
MI
Other
Enumeration date
04/24/2018
Last updated
04/24/2018
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