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Organization

EBONY PUTMAN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EBONY PUTMAN (OWNER)
(313) 220-4957
Entity
Organization

Contact information

Practice address
12744 PLYMOUTH, DETROIT, MI 48227
(313) 931-1242
(313) 931-1242
Mailing address
12744 PLYMOUTH, DETROIT, MI 48227
(313) 931-1242
(313) 931-1242

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MI

Other

Enumeration date
09/05/2012
Last updated
05/09/2013
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