Individual
MEGAN PODLASKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21751 ECORSE RD, TAYLOR, MI 48180-1846
(313) 406-4493
Mailing address
18510 PARKE LN, GROSSE ILE, MI 48138-1036
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301015642
MI
Other
Enumeration date
08/28/2013
Last updated
08/28/2013
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