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Individual

PHILLIP CHARLES WEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ADDICTION COUNSELOR

Contact information

Practice address
1800 W BETHUNE ST APT 104, DETROIT, MI 48206-2674
(313) 778-2696
Mailing address
1800 BETHUNE, APT.104, DETROIT, MI 48206
(313) 778-2696

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10082
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141928000
MI
Enumeration date
04/14/2008
Last updated
04/14/2008
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