| Ebony Putman | |
|
12744 Plymouth Detroit MI 48227 | |
| (313) 931-1242 | |
| (313) 931-1242 |
| Full Name | Ebony Putman |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 12744 Plymouth, Detroit, Michigan |
| Authorized Official Name and Position | Ebony Putman (OWNER) |
| Authorized Official Contact | 3132204957 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebony Putman 12744 Plymouth Detroit MI 48227 Ph: (313) 931-1242 | Ebony Putman 12744 Plymouth Detroit MI 48227 Ph: (313) 931-1242 |
| NPI Number | 1578812657 |
|---|---|
| Provider Enumeration Date | 09/05/2012 |
| Last Update Date | 05/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578812657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Michigan) | Primary |
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