Organization
MICHIGAN FORENSIC INTERVENTION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA MARION (MENTAL HEALTH COUNSELOR)
(586) 945-8034
Entity
Organization
Contact information
Practice address
21821 LAKEVIEW ST, SAINT CLAIR SHORES, MI 48080-4057
(586) 945-8034
Mailing address
21821 LAKEVIEW ST, SAINT CLAIR SHORES, MI 48080-4057
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
SA0500473
MI
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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