Organization
MELANATED CROWN MENTAL HEALTH AND CONSULTING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NERISSA A LEGG LPC (OWNER)
(734) 431-8503
Entity
Organization
Contact information
Practice address
40315 MICHIGAN AVE # 1081, CANTON, MI 48188-2908
(734) 431-8503
Mailing address
9517 LAKESIDE DR, YPSILANTI, MI 48197-3033
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/03/2021
Last updated
11/08/2021
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