Individual
MRS. MARCIA PARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3840 FAIRVIEW ST, DETROIT, MI 48214-1608
(313) 331-8990
Mailing address
3840 FAIRVIEW ST, DETROIT, MI 48214-1608
(313) 331-8990
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063545556
GENESIS HOUSE III
MI
05
—
3022440
—
MI
Enumeration date
04/04/2007
Last updated
07/09/2007
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