TIA LANISE BRAXTON

DETROIT, MI
NPI1154767143
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MI  6801092238)
Enumeration Date2013-05-16
Last Update Date2013-05-16
Business Address
-- TIA LANISE BRAXTON LMSW
2051 W GRAND BLVD
DETROIT, MI 48208-1105
Phone number: 313-961-2919
Mailing Address
-- TIA LANISE BRAXTON LMSW
2051 W GRAND BLVD
DETROIT, MI 48208-1105
Phone number: