Individual
MS. ANGELICA LATRICE JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9560 GRANDMONT AVE, DETROIT, MI 48227-1029
(313) 320-2306
Mailing address
9560 GRANDMONT AVE, DETROIT, MI 48227-1029
(313) 320-2306
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
247200000X
Other Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922352723
—
MI
Enumeration date
10/31/2012
Last updated
02/24/2016
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