Individual
MS. VICKIE MCTAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAC-M
Contact information
Practice address
2409 CALVERT ST, DETROIT, MI 48206-1533
(313) 869-6905
Mailing address
35390 VAN BORN RD APT 303, WAYNE, MI 48184-3317
(734) 934-7701
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
MI
Other
Enumeration date
01/22/2010
Last updated
07/21/2022
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