Individual
GERALD TERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15751 LAWTON ST, DETROIT, MI 48238-1425
(313) 346-2026
Mailing address
15751 LAWTON ST, DETROIT, MI 48238-1425
(313) 346-2026
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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