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General NPI Number Information
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NPI Number | 1477666865
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Entity Type | Organization
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Legal Business Name | MULTICULTURAL RESOURCE AGENCY INC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18615 NORWOOD STREET
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City | DETROIT
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State | MI
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Zip | 48234
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Country | US
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Telephone | 313-368-0000
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Fax | 313-366-8489
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Provider Business Mailing Address
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Address Line | PO BOX 34113
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City | DETROIT
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State | MI
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Zip | 48234
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Country | US
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Telephone | 313-368-0000
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Fax | 313-366-8469
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. EARNEST BRADLEY
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Credential | MSW CSW ACSW LCSW
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Telephone | 313-368-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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