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1104059567
LAVERNE D. SMITH-RUDOLPH
DETROIT, MI
NPI
1104059567
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2009-09-01
Last Update Date
2009-09-01
Business Address
Mrs. LAVERNE D. SMITH-RUDOLPH
17131 GITRE ST
DETROIT, MI 48205-3161
Phone number: 313-245-4357
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Mailing Address
Mrs. LAVERNE D. SMITH-RUDOLPH
17131 GITRE ST
DETROIT, MI 48205-3161
Phone number: 313-245-4357
Copy
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