Individual
MRS. LAURA MARIE KHALIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.AD.
Contact information
Practice address
22790 KELLY RD, SUITE A, EASTPOINTE, MI 48021-2019
(586) 771-7600
(586) 771-7617
Mailing address
22790 KELLY RD, SUITE A, EASTPOINTE, MI 48021-2019
(586) 771-7600
(586) 771-7617
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
SA0500442
MI
Other
Enumeration date
02/09/2015
Last updated
07/03/2016
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