Individual
THEODORE PAUL FARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
2300 HAGGERTY RD, SUITE 2160, WEST BLOOMFIELD, MI 48323-2184
(248) 960-5106
(248) 960-5532
Mailing address
3689 DARCY DR, BLOOMFIELD TOWNSHIP, MI 48301-2126
(248) 644-0253
(248) 644-0253
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401008983
MI
Other
Enumeration date
02/28/2007
Last updated
09/07/2009
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