Healthcare Provider Details

I. General information

NPI: 1396218921
Provider Name (Legal Business Name): JAMES MICHAEL DEHRING III
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2019
Last Update Date: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 N MONROE ST
MONROE MI
48162-9297
US

IV. Provider business mailing address

302 BEACHWALK TRL
LUNA PIER MI
48157-9402
US

V. Phone/Fax

Practice location:
  • Phone: 734-384-3402
  • Fax:
Mailing address:
  • Phone: 313-283-3314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: