Individual
MR. PHILLIP GERARD LACOURSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.,L.L.P.
Contact information
Practice address
8150 E 13 MILE RD STE 100, WARREN, MI 48093-8711
(586) 558-7472
Mailing address
8150 E 13 MILE RD STE 100, WARREN, MI 48093-8711
(586) 558-7472
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6301007404
MI
Other
Enumeration date
05/08/2009
Last updated
05/08/2009
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