Individual
CARLISA MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7310 WOODWARD AVE, DETROIT, MI 48202-3165
(313) 896-4441
Mailing address
7310 WOODWARD AVE, DETROIT, MI 48202-3165
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6451006595
MI
101Y00000X
Counselor
—
—
Other
Enumeration date
05/29/2020
Last updated
01/10/2022
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