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General NPI Number Information
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NPI Number | 1710613799
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Entity Type | Organization
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Legal Business Name | JUST TRI RECOVERY
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Dates
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Enumeration Date | 08/01/2022
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 1250 MIDDLEBELT RD
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City | INKSTER
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State | MI
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Zip | 48141-1628
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Country | US
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Telephone | 734-858-7261
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Fax | 734-661-6371
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Provider Business Mailing Address
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Address Line | 29465 HAZELWOOD ST
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City | INKSTER
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State | MI
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Zip | 48141-1541
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Country | US
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Telephone | 734-334-6623
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARLA J EDWARDS-WHEELER
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Credential | LMSW
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Telephone | 734-334-6623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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