Individual
MR. VICTOR D HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW, PA-C
Contact information
Practice address
6001 W OUTER DR STE 207, DETROIT, MI 48235-2626
(313) 966-2800
(313) 966-7797
Mailing address
6001 W OUTER DR STE 207, DETROIT, MI 48235-2626
(313) 966-2800
(313) 966-7797
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6801090790
MI
363AM0700X
Medical Physician Assistant
Primary
5601009949
MI
Other
Enumeration date
09/09/2014
Last updated
04/23/2025
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