Organization
DBT GYM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAYLA GLASS LLP (THERAPIST)
(248) 763-2399
Entity
Organization
Contact information
Practice address
25430 SOUTHFIELD RD # A102, SOUTHFIELD, MI 48075-1957
(248) 763-2399
Mailing address
25430 SOUTHFIELD RD # A102, SOUTHFIELD, MI 48075-1957
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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