Dore, Russell Lee

Dore, Russell Lee is an individual health care provider with primary practice located at 215 E Main St #201, Northville MI 48167-1681. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Dore, Russell Lee can be contacted via phone (248) 348-1100.

Contact Information

Primary practice address
215 E Main St #201 Northville MI 48167-1681
Phone: (248) 348-1100
Fax: (248) 348-3410
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6301001278 Michigan

Profile Details

NPI number 1114125200
LBN Legal business name Dore, Russell Lee
Credentials EDD, LP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2007
Last updated Jul 10th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114125200 NPPES
Michigan Other 143449 VALUE OPTIONS
Michigan Other 68OH201330 VALUE OPTIONS

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