Organization
SOUTHPOINTE COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WAYNE GORMAN MA.LLP (PSYCHOLOGIST)
(734) 365-4119
Entity
Organization
Contact information
Practice address
1927 EUREKA RD, WYANDOTTE, MI 48192-6009
(734) 365-4119
(734) 281-0188
Mailing address
1927 EUREKA, WYANDOTTE, MI 48192
(734) 365-4119
(734) 281-0188
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6301005878
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6301005878
—
MI
Enumeration date
05/02/2012
Last updated
05/02/2012
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