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NPI Code Detail

MEDICARE: MRS. LORETTA MITTON MA, LLP

MEDICARE:  MRS. LORETTA  MITTON  MA, LLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor6301014832MI

General Provider Information

NPI Number : 1649551268
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LORETTA MITTON MA, LLP
Provider Business Mailing Address
First Line : 791 TANGLEWOOD DR
Second Line :
City : MADISON HEIGHTS
State : MI
Zip : 48071-2209
Country : US
Telephone Number : 248-506-7001
Fax Number :
Provider Business Practice Location Address
First Line : 19900 E 10 MILE RD
Second Line : SUITE 102
City : SAINT CLAIR SHORES
State : MI
Zip : 48080-4412
Country : US
Telephone Number : 586-776-3366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2011
Last Update Date : 01/09/2014

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Directions to “ MRS. LORETTA MITTON MA, LLP” Practice Location

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