| Doctor Name: | MR. MICHAEL ANTHONY DEMOTT |
| NPI Number: | 1093726903 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, LPC |
| License Number: | 6401010517 |
| Business Practice Address: | 8623 N Wayne Rd Suite 123 Westland, MI - 481851137 |
| Business Phone Number: | 7343670469 |
| Business Fax Number: | |
| Mailing Address: | 8623 N Wayne Rd, Suite 123 WESTLAND |
| State: | MI |
| Postal Code: | 481851137 |
| Phone Number: | 7343670469 |
| Fax Number: | |
| NPI Enumeration Date: | 08/10/2006 |
| NPI Last Update Date: | 04/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 6401010517 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |