Individual
MR. THEADORE ALGER MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CACM,CSOTS
Contact information
Practice address
8097 DECATUR ST, DETROIT, MI 48228-2721
(313) 846-5020
(313) 846-3468
Mailing address
8097 DECATUR ST, DETROIT, MI 48228-2721
(313) 846-5020
(313) 846-3468
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
25572CSOTS
MI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
104888 CACM
MI
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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