Healthcare Provider Details

I. General information

NPI: 1033292396
Provider Name (Legal Business Name): KAURA H. AFRICA MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8062 ORTONVILLE RD
CLARKSTON MI
48348
US

IV. Provider business mailing address

31000 6 MILE RD
LIVONIA MI
48152-3402
US

V. Phone/Fax

Practice location:
  • Phone: 248-625-2970
  • Fax:
Mailing address:
  • Phone: 989-948-7630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401009559
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: