NASHAWN DEAN RUSSEL LARIVIERE

CANTON, MI
NPI1053127910
Former NameMISTER K STEVENS
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2024-12-05
Last Update Date2024-12-05
Business Address
NASHAWN DEAN RUSSEL LARIVIERE CPRC
50430 SCHOOL HOUSE RD
CANTON, MI 48187-5910
Phone number: 734-495-1722
Mailing Address
NASHAWN DEAN RUSSEL LARIVIERE CPRC
50430 SCHOOL HOUSE RD
CANTON, MI 48187-5910
Phone number: 734-495-1722
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