Colvin, Teri Laurie
Colvin, Teri Laurie is an sole proprietor health care provider with primary practice located at 1852 W Grand Blvd , Detroit MI 48208-1006. She recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as her primary health care specialty. Colvin, Teri Laurie can be contacted via phone (313) 894-8444.Contact Information
Primary practice address
1852 W Grand Blvd
Detroit MI 48208-1006
Phone: (313) 894-8444
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness | 320800000X | 820174 | Michigan |
Profile Details
| NPI number | 1295373504 |
|---|---|
| LBN Legal business name | Colvin, Teri Laurie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 17th, 2019 |
| Last updated | Dec 17th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295373504 | NPPES |
| Michigan | MEDICAID | 38-1917278 |
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