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Individual

MS. GERALDINE GERRY BASKERVILLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
17515 W 9 MILE RD STE 720, SOUTHFIELD, MI 48075-4403
(248) 423-1728
(248) 773-1966
Mailing address
17515 W 9 MILE RD STE 720, SOUTHFIELD, MI 48075-4403
(248) 423-1728
(248) 773-1966

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401003813
MI

Other

Enumeration date
06/10/2010
Last updated
06/10/2010
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