Individual provider · Type 1 NPI
Lora Diane Maxson, LLPC
Professional Counselor · Detroit, MI
NPI number
1104117365
Active
Practice location
79 W Alexandrine St
Detroit, MI 48201-2015
Mailing address
24138 Pennie St
Dearborn Heights, MI 48125-1552
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 6401011557 (MI) |
Professional Counselor: Definition to come...
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About NPI 1104117365
Lora Diane Maxson, LLPC's National Provider Identifier is 1104117365, issued on Apr 22, 2011. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Detroit, MI. The record was last updated on Sep 7, 2016.