Individual
WANDA TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29680 MARSHALL DR, WESTLAND, MI 48186-7359
(313) 283-1535
Mailing address
29680 MARSHALL DR, WESTLAND, MI 48186-7359
(313) 283-1535
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401014697
MI
Other
Enumeration date
12/05/2015
Last updated
12/05/2015
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