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1194267054
CHANELL EZELL
DETROIT, MI
NPI
1194267054
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-11-09
Last Update Date
2016-11-09
Business Address
-- CHANELL EZELL
12010 LINWOOD ST
DETROIT, MI 48206-1108
Phone number: 313-867-1090
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Mailing Address
-- CHANELL EZELL
12010 LINWOOD ST
DETROIT, MI 48206-1108
Phone number: 313-867-1090
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