Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 6401015916 | MI |
N | 101Y00000X | Counselor | 6401017219 | MI |
NPI | 1003344565 |
---|---|
Provider Name | Alison Christine Maples |
First Address | Hazel Park, MI 48030-2668 |
Second Address | Royal Oak, MI 48073-2803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2017 |
Last Update Date | 28/03/2019 |