Individual
DATARA MICHENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
850 W UNIVERSITY DR, ROCHESTER, MI 48307-1845
(248) 601-3111
Mailing address
PO BOX 530432, LIVONIA, MI 48153-0432
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401013542
MI
Other
Enumeration date
03/20/2013
Last updated
03/20/2013
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