Individual
LORI VANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30500 VAN DYKE AVE, WARREN, MI 48093-2195
(586) 558-6868
(586) 558-6893
Mailing address
30500 VAN DYKE AVE, WARREN, MI 48093-2195
(586) 558-6868
(586) 558-6893
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401014315
MI
Other
Enumeration date
06/19/2014
Last updated
06/19/2014
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