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General NPI Number Information
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NPI Number | 1861317869
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Entity Type | Individual
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Provider Name | LIA COHEN
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Gender | Female
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 34208 VAN DYKE AVE
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-4647
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Country | US
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Telephone | 586-758-6670
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Fax |
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Provider Business Mailing Address
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Address Line | 21212 PARKWAY ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48082-1215
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Country | US
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Telephone | 586-758-6670
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 4704382937
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License Number State | MI
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