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General NPI Number Information
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NPI Number | 1245696137
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Entity Type | Individual
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Provider Name | ALICE RABY
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Gender | Female
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Dates
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Enumeration Date | 01/07/2016
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 2251 ANTIETAM AVE
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City | DETROIT
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State | MI
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Zip | 48207-3879
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Country | US
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Telephone | 313-878-3654
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FORD PL STE 3A
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City | DETROIT
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State | MI
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Zip | 48202-3450
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Country | US
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Telephone | 248-662-8912
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401004035
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401004035
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License Number State | MI
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