NPI 1942737853

Vicky Avery

Practitioner Prevention Professional Detroit, MI

Practice location

Address: 13560 E McNichols Rd, Detroit, MI 48205-3426
Phone: (313) 883-3300
Fax: (313) 731-0156
Mailing address: 62 Massachusetts St, Highland Park, MI 48203-3537

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 823032 (MI)

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Registry record

NPI: 1942737853
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 May 2017
Record last updated: 21 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.