Individual
KELLY DEVONNE MYRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 344-9099
(313) 893-1735
Mailing address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 344-9099
(313) 893-1735
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401011597
MI
324500000X
Substance Abuse Rehabilitation Facility
820317
MI
Other
Enumeration date
06/22/2012
Last updated
11/10/2021
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