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Individual

DAVE WESLEY BUSSELL II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
34841 VETERANS PLZ, WAYNE, MI 48184-1733
(313) 292-7640
(313) 292-9270
Mailing address
34841 VETERANS PLZ, WAYNE, MI 48184-1733
(313) 292-7640
(313) 292-9270

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6361004483
MI

Other

Enumeration date
09/02/2017
Last updated
06/30/2020
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