Organization
LIFE PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETTY ANN RICKMAN LMSW,LPC (THERAPIST)
(313) 799-0093
Entity
Organization
Contact information
Practice address
2006 S WAYNE RD, WESTLAND, MI 48186-5428
(313) 799-0093
(734) 467-3965
Mailing address
2006 S WAYNE RD, WESTLAND, MI 48186-5428
(313) 799-0093
(734) 467-3965
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6401006504
MI
251S00000X
Community/Behavioral Health Agency
6801035053
MI
Other
Enumeration date
10/25/2012
Last updated
10/25/2012
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