Individual
CECIL COSEY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11000 W MICNICHOLS, DETROIT, MI 48238
(313) 717-8002
Mailing address
11000 W MCNICHOLS RD, DETROIT, MI 48221-2357
(313) 717-8002
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
MI
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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