Individual
SANDRA LYNESS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4252 STONELEIGH RD, BLOOMFIELD, MI 48302-2022
(248) 645-0299
Mailing address
4252 STONELEIGH RD, BLOOMFIELD, MI 48302-2022
(248) 645-0299
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301000746
MI
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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