Diane G Russell Therapy Services Llc | |
640 Griswold St Suite 300 Northville MI 48167-1690 | |
(248) 996-5383 | |
(586) 773-6093 |
Full Name | Diane G Russell Therapy Services Llc |
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Speciality | Social Worker - Clinical |
Location | 640 Griswold St, Northville, Michigan |
Authorized Official Name and Position | Diane G Russell (SOCIAL WORKER) |
Authorized Official Contact | 2489965383 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Diane G Russell Therapy Services Llc 640 Griswold St Suite 300 Northville MI 48167-1690 Ph: (248) 996-5383 | Diane G Russell Therapy Services Llc 640 Griswold St Suite 300 Northville MI 48167-1690 Ph: (248) 996-5383 |
NPI Number | 1184969719 |
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Provider Enumeration Date | 12/07/2012 |
Last Update Date | 12/07/2012 |
Identifier | Type | State | Issuer |
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1184969719 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 6801066657 (Michigan) | Primary |
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