Individual
MARCIA BONAHOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
16824 KERCHEVAL PL, GROSSE POINTE, MI 48230-1500
(313) 882-2150
Mailing address
16824 KERCHEVAL PL, GROSSE POINTE, MI 48230-1500
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301010140
MI
103TB0200X
Cognitive & Behavioral Psychologist
6301010140
MI
Other
Enumeration date
10/19/2007
Last updated
10/19/2007
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