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1578818837
CARLOS T LEAGUE
DETROIT, MI
NPI
1578818837
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MI developmentplan)
Enumeration Date
2012-07-23
Last Update Date
2012-07-23
Business Address
-- CARLOS T LEAGUE
445 LEDYARD ST
DETROIT, MI 48201-2641
Phone number: 313-962-9446
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Mailing Address
-- CARLOS T LEAGUE
445 LEDYARD ST
DETROIT, MI 48201-2641
Phone number: 313-962-9446
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