Individual
MADELYN WESOLOWSKI LEPAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LLP
Contact information
Practice address
124 WEST GATES, ROMEO, MI 48065
(586) 752-9696
(586) 752-9157
Mailing address
36975 UTICA ROAD, SUITE 103, CLINTON TOWNSHIP, MI 48036
(586) 226-3440
(586) 226-3672
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007259
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L938486
DEPT OF COMMUNITY HEALTH
MI
Enumeration date
12/04/2006
Last updated
07/08/2007
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