Individual provider · Type 1 NPI

Ellaina Renee Rudolph

Addiction (Substance Use Disorder) Counselor · Highland Park, MI

NPI number 1730668906 Active

Practice location

12501 Hamilton Ave
Highland Park, MI 48203-3243

Call (313) 865-1580 Map

Mailing address

1989 Virginia Park St
Detroit, MI 48206-2421

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1730668906

Ellaina Renee Rudolph's National Provider Identifier is 1730668906, issued on Aug 9, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Highland Park, MI. The record was last updated on Aug 9, 2018.