Organization
GOEDERT THERAPEUTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEAD GOEDERT LMSW (CLINICAL THERAPIST)
(313) 850-0469
Entity
Organization
Contact information
Practice address
415 S WEST ST, SUITE 150, ROYAL OAK, MI 48067-2521
(313) 850-0469
Mailing address
415 S WEST ST, SUITE 150, ROYAL OAK, MI 48067-2521
(313) 850-0469
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6801089319
MI
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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