Individual
ALICE VIRGINIA DURDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW,ACC
Contact information
Practice address
3737 LAWTON ST, DETROIT, MI 48208-2500
(313) 361-6136
Mailing address
1920 CHENE CT, APT 203, DETROIT, MI 48207-4984
(313) 361-6136
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811094998
—
MI
Enumeration date
06/12/2007
Last updated
07/08/2007
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