Individual
MR. CHARLES A. TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1852 W GRAND BLVD, DETROIT, MI 48208
(313) 894-8444
(313) 894-5542
Mailing address
1852 W GRAND BLVD, DETROIT, MI 48208
(313) 894-8444
(313) 894-5542
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
820774
MI
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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