Willis, Gerald

Willis, Gerald is an individual health care provider with primary practice located at 13220 Woodward Ave , Highland Park MI 48203-3610. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Willis, Gerald can be contacted via phone (313) 852-1637.

Contact Information

Primary practice address
13220 Woodward Ave Highland Park MI 48203-3610
Phone: (313) 852-1637
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X Michigan

Profile Details

NPI number 1952428286
LBN Legal business name Willis, Gerald
Credentials F.S.A.C.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2007
Last updated Jul 26th, 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 1952428286 NPPES
Michigan MEDICAID 3022440
Michigan Other 1740313238

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