Provider Information for 1417110040
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Ms. DANITA LYTRICE THOMPSON LMSW
Sex: Female
NPI: 1417110040
Last Updated: 2008-07-03
Certification Date:
Certification Date:
Details
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| NPI | 1417110040 | ||||||||
| Enumeration Date | 2008-07-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6130 COCHISE DR WEST BLOOMFIELD, MI 48322-2361 United States Phone: 248-752-5080 | Fax: | ||||||||
| Primary Practice Address | 6130 COCHISE DR WEST BLOOMFIELD, MI 48322-2361 United States Phone: 248-752-5080 | Fax: | ||||||||
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