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Individual

MR. ADOLPHUS HEATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2081 W GRAND BLVD, DETROIT, MI 48208-1105
(313) 895-0500
Mailing address
6385 RADNOR ST, DETROIT, MI 48224-1261
(313) 283-6956

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
820123
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
820123
MI
Enumeration date
08/27/2012
Last updated
08/27/2012
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