Individual
MRS. TONI RENEE PRUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19401 NORTHLINE RD, SOUTHGATE, MI 48195-2277
(734) 785-7718
Mailing address
28773 WALES DR, CHESTERFIELD, MI 48047-1743
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301013605
MI
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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