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Individual

DR. PAUL GERARD CHRUSTOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LP

Contact information

Practice address
2001 W WARREN AVE, DETROIT, MI 48208-2216
(313) 748-6439
Mailing address
5673 GLASGOW DR, TROY, MI 48085-3156

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301012165
MI
103TC0700X
Clinical Psychologist
6301012165
MI

Other

Enumeration date
09/17/2018
Last updated
09/17/2018
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