Individual
BABY PALLIYUDETHEKKATHIL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2785 E GRAND BLVD, DETROIT, MI 48211-2003
(562) 826-0574
Mailing address
29577 EQUESTRIAN APT 40104, FARMINGTON HILLS, MI 48331-4948
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6851117503
MI
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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