Provider First Line Business Practice Location Address:
711 WEST THIRTEEN MILE RD
Provider Second Line Business Practice Location Address:
BETTY THACK MA LPC
Provider Business Practice Location Address City Name:
MADISON HEIGHTS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-761-9771
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/17/2015