Provider Demographics
NPI:1497986988
Name:TOWNES, IRITA V
Entity Type:Individual
Prefix:
First Name:IRITA
Middle Name:V
Last Name:TOWNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 GLENDALE ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48203-3231
Mailing Address - Country:US
Mailing Address - Phone:313-868-0721
Mailing Address - Fax:
Practice Address - Street 1:211 GLENDALE ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:MI
Practice Address - Zip Code:48203-3231
Practice Address - Country:US
Practice Address - Phone:313-868-0721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health