Outsidethebox Detroit Therapy | |
4131 Clippert St Dearborn Hts MI 48125-2732 | |
(313) 680-0019 | |
Not Available |
Full Name | Outsidethebox Detroit Therapy |
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Speciality | Social Worker |
Location | 4131 Clippert St, Dearborn Hts, Michigan |
Authorized Official Name and Position | Bradley Allan Lake (CEO/THERAPIST) |
Authorized Official Contact | 3136800019 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Outsidethebox Detroit Therapy 23131 Michigan Ave # 1046 Dearborn MI 48124-2020 Ph: (313) 680-0019 | Outsidethebox Detroit Therapy 4131 Clippert St Dearborn Hts MI 48125-2732 Ph: (313) 680-0019 |
NPI Number | 1003631987 |
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Provider Enumeration Date | 11/18/2024 |
Last Update Date | 11/18/2024 |
Certification Date | 11/17/2024 |
Identifier | Type | State | Issuer |
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1003631987 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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104100000X | Social Worker | (* (Not Available)) | Primary |