Organization
HENRY FORD BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY RAE QUEEN L.P.C. (PSYCHOTHERAPIST)
(586) 226-7026
Entity
Organization
Contact information
Practice address
15420 19 MILE RD, CLINTON TOWNSHIP, MI 48038-6339
(586) 226-7007
(586) 226-7033
Mailing address
15420 19 MILE RD, CLINTON TOWNSHIP, MI 48038-6339
(586) 226-7007
(586) 226-7033
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
6401007827
MI
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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