Provider Demographics
NPI:1073819074
Name:COMERFORD, NATHAN MICHAEL (MA)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:MICHAEL
Last Name:COMERFORD
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Gender:M
Credentials:MA
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Mailing Address - Street 1:31275 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2558
Mailing Address - Country:US
Mailing Address - Phone:248-932-7799
Mailing Address - Fax:248-932-0220
Practice Address - Street 1:31275 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 120
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2558
Practice Address - Country:US
Practice Address - Phone:248-932-7799
Practice Address - Fax:248-932-0220
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6401010507101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional