Organization
DETROIT WAYNE MENTAL HEALTH AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACIE DURANT CPA (CHIEF FINANCIAL OFFICER)
(313) 344-9099
Entity
Organization
Contact information
Practice address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 344-9099
Mailing address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 344-9090
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
103TF0000X
Family Psychologist
—
—
Other
Enumeration date
02/14/2014
Last updated
10/24/2016
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