Provider Demographics
NPI:1295588689
Name:LEISURE, PARRIS CHARMAI
Entity type:Individual
Prefix:
First Name:PARRIS
Middle Name:CHARMAI
Last Name:LEISURE
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 1:1146 LEINBACH AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0035
Mailing Address - Country:US
Mailing Address - Phone:734-377-3576
Mailing Address - Fax:
Practice Address - Street 1:17667 PIERSON ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-2520
Practice Address - Country:US
Practice Address - Phone:313-531-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health