Individual
MISS DEANNA LYNN LIBRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7701
(734) 287-4602
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401011590
MI
Other
Enumeration date
04/16/2012
Last updated
01/02/2013
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