Individual
MARK ANDREW ILGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
4250 PLYMOUTH RD, ANN ARBOR, MI 48109-2700
(734) 764-6443
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
6301013529
MI
103TC0700X
Clinical Psychologist
Primary
6301013529
MI
Other
Enumeration date
02/27/2007
Last updated
07/15/2020
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