Individual
ELLEN MAYFIELD-FLEMING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MALLP
Contact information
Practice address
42669 GARFIELD RD, CLINTON TWP, MI 48038-5036
(586) 412-5321
Mailing address
12850 FOUNTAIN SQ, DAVISBURG, MI 48350-2552
(248) 634-6303
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301010626
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
750910642
BLUE CROSS
MI
Enumeration date
11/20/2008
Last updated
11/20/2008
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