Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 6401004451 | MI |
NPI | 1003046988 |
---|---|
Provider Name | Mrs. Joyce Ann Gulley |
First Address | Redford, MI 48239-3244 |
Second Address | Redford, MI 48239-3244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2009 |
Last Update Date | 25/07/2009 |