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1861819955
LAVIETTRIEA TERRELL
DETROIT, MI
NPI
1861819955
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-03-26
Last Update Date
2014-03-26
Business Address
-- LAVIETTRIEA TERRELL
16647 WYOMING ST
DETROIT, MI 48221-2848
Phone number: 313-342-3606
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Mailing Address
-- LAVIETTRIEA TERRELL
16647 WYOMING ST
DETROIT, MI 48221-2848
Phone number: 313-342-3606
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