Provider Demographics
NPI:1275953952
Name:FOREMAN, VERA (MAOM,BBA,FAODP)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:MAOM,BBA,FAODP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 WEBB ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48206-1283
Mailing Address - Country:US
Mailing Address - Phone:313-883-5614
Mailing Address - Fax:
Practice Address - Street 1:2015 WEBB ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48206-1283
Practice Address - Country:US
Practice Address - Phone:313-883-5614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health