Organization
DEBRA MARY GREGORY PC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA MARY GREGORY LCSW (CLINICAL SOCIAL WORKER)
(248) 568-1344
Entity
Organization
Contact information
Practice address
7130 WALNUT LAKE ROAD, WEST BLOOMFIELD, MI 48323
(248) 568-1344
(248) 922-9040
Mailing address
5639 SASHABAW RD, CLARKSTON, MI 48346-3149
(248) 568-1344
(248) 922-9040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801033761
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8008965160
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/14/2010
Last updated
10/14/2010
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