| Wws | |
|
11443 E 13 Mile Rd Ste 401 Warren MI 48093-6523 | |
| (313) 335-7435 | |
| Not Available |
| Full Name | Wws |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 11443 E 13 Mile Rd Ste 401, Warren, Michigan |
| Authorized Official Name and Position | Lavita Sophia Modest (BUSINESS OWNER) |
| Authorized Official Contact | 3139261683 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wws 30957 Lorraine Ave Warren MI 48093-8014 Ph: (313) 926-1683 | Wws 11443 E 13 Mile Rd Ste 401 Warren MI 48093-6523 Ph: (313) 335-7435 |
| NPI Number | 1184312704 |
|---|---|
| Provider Enumeration Date | 05/01/2023 |
| Last Update Date | 05/01/2023 |
| Certification Date | 05/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184312704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (NU) | Primary |
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