Individual
CARLIE ELAINE ADDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35054 23 MILE RD STE 104, NEW BALTIMORE, MI 48047-2019
(586) 863-4000
Mailing address
52430 BASE ST, NEW BALTIMORE, MI 48047-1571
(517) 282-1552
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801104843
MI
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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