| Blue Pearl Wellness, Pllc | |
|
17344 W 12 Mile Rd Ste 205 Southfield MI 48076-6321 | |
| (248) 990-2722 | |
| Not Available |
| Full Name | Blue Pearl Wellness, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 17344 W 12 Mile Rd Ste 205, Southfield, Michigan |
| Authorized Official Name and Position | Manjula Kaza-egan (PRACTITIONER) |
| Authorized Official Contact | 2482006061 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Pearl Wellness, Pllc 13116 Balfour Ave Huntington Woods MI 48070-1701 Ph: (248) 200-6061 | Blue Pearl Wellness, Pllc 17344 W 12 Mile Rd Ste 205 Southfield MI 48076-6321 Ph: (248) 990-2722 |
| NPI Number | 1578117990 |
|---|---|
| Provider Enumeration Date | 07/25/2019 |
| Last Update Date | 07/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578117990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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