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Individual

DR. SARAH LIETZOW WITHERELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D., LLP

Contact information

Practice address
2751 E JEFFERSON AVE, DETROIT, MI 48207-4180
(313) 993-3434
(313) 993-3421
Mailing address
101 E ALEXANDRINE ST, DETROIT, MI 48201-2011
(313) 831-5535
(313) 324-8782

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301015705
MI
390200000X
Student in an Organized Health Care Education/Training Program
MI

Other

Enumeration date
09/07/2010
Last updated
03/13/2014
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