Individual
MR. GREGORY DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6451 SCHAEFER RD, DEARBORN, MI 48126-2212
(313) 945-8138
(313) 203-3390
Mailing address
2651 SAULINO CT, DEARBORN, MI 48120-1556
(313) 842-7010
(313) 842-5150
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6801101945
MI
1041C0700X
Clinical Social Worker
6801101945
MI
Other
Enumeration date
01/04/2018
Last updated
04/05/2021
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