| Heal Thyself Therapeutics, Llc | |
|
1100 Corporate Office Dr Ste 320 Milford MI 48381-5002 | |
| (810) 434-7933 | |
| Not Available |
| Full Name | Heal Thyself Therapeutics, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1100 Corporate Office Dr Ste 320, Milford, Michigan |
| Authorized Official Name and Position | Derrick Jerome Jackson (THERAPIST) |
| Authorized Official Contact | 8104347933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heal Thyself Therapeutics, Llc 34326 Sheridan St Westland MI 48185-8511 Ph: (810) 434-7933 | Heal Thyself Therapeutics, Llc 1100 Corporate Office Dr Ste 320 Milford MI 48381-5002 Ph: (810) 434-7933 |
| NPI Number | 1003419136 |
|---|---|
| Provider Enumeration Date | 11/20/2020 |
| Last Update Date | 12/01/2020 |
| Certification Date | 12/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003419136 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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