Individual
SAMUEL DONALDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4479 CONCORD ST, DETROIT, MI 48207-1908
(313) 727-3382
Mailing address
4479 CONCORD ST, DETROIT, MI 48207-1908
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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