DIANE P CUSHING LPC
Managed Care Organizations at Long Lake Rd, Troy, MI

License number
Michigan 6401005517
Category
Managed Care Organizations
Type
Point of Service
Owner
Name: MS. DIANE P CUSHING LPC
Title: LICENSED PROFESSIONAL COUNSELOR
Phone: (248) 680-0796
Address
Address
2888 E Long Lake Rd STE 145, Troy, MI 48085
National Provider ID: 1770940884
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DIANE P. CUSHING, L.P.C., PC

Troy, MI

Registration:
Aug 19, 1994
Addresses:
2888 E Long Lk Rd #145, Troy, MI 48098 (Physical)
Michigan (Mailing)
State ID:
153452
Business type:
Domestic Professional Service Corporation
Agent:
Diane P. Cushing

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