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Individual

MATTHEW LACASSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3901 CHRYSLER DR STE 1A, DETROIT, MI 48201-2167
(313) 993-3964
Mailing address
400 MACK AVE, DETROIT, MI 48201-2136
(313) 448-9006

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
5101021692
MI
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
5101021692
MI
2084P0800X
Psychiatry Physician
5101021692
MI
2084P0804X
Child & Adolescent Psychiatry Physician
5101021692
MI

Other

Enumeration date
05/15/2015
Last updated
06/06/2023
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