Individual
MS. DEBRA GAYLE HENDREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED BACHELOR'S
Contact information
Practice address
570 KIRTS BLVD STE 231, TROY, MI 48084-4156
(248) 269-1309
Mailing address
825 PARK AVE, ROYAL OAK, MI 48067-2227
(248) 320-9177
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802076082
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6802076082
BACHELOR'S SOCIAL WORKER LICENSE
MI
Enumeration date
05/24/2018
Last updated
05/24/2018
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