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NPI Code Detail

MEDICARE: MRS. GABRIELLE ELIZABETH STREFFON LLPC

MEDICARE:  MRS. GABRIELLE ELIZABETH STREFFON  LLPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor6401009830MI

General Provider Information

NPI Number : 1366477986
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GABRIELLE ELIZABETH STREFFON LLPC
Provider Business Mailing Address
First Line : 19634 SAWYER ST
Second Line :
City : DETROIT
State : MI
Zip : 48228-3263
Country : US
Telephone Number : 313-240-4162
Fax Number :
Provider Business Practice Location Address
First Line : 43825 MICHIGAN AVE
Second Line :
City : CANTON
State : MI
Zip : 48188-2551
Country : US
Telephone Number : 734-397-3088
Fax Number : 734-397-2892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. GABRIELLE ELIZABETH STREFFON LLPC” Practice Location

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