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Individual

CAROL S AGNEW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
42627 GARFIELD RD STE 217, CLINTON TOWNSHIP, MI 48038-5032
(248) 210-5018
Mailing address
42627 GARFIELD RD STE 217, CLINTON TOWNSHIP, MI 48038-5032
(248) 210-5018

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4101006139
MI
106H00000X
Marriage & Family Therapist
Primary
4101006139
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12458685
CAQH
Enumeration date
08/16/2006
Last updated
06/11/2019
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