Individual
MR. SAMUEL P GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MALLP, LPC, CSW
Contact information
Practice address
53950 VAN DYKE AVE, SUITE 210B, SHELBY TOWNSHIP, MI 48316-1819
(586) 781-8400
(586) 781-8300
Mailing address
16991 DUBLAINE, BEVERLY HILLS, MI 48025
(248) 433-1069
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6801057702
MI
Other
Enumeration date
12/04/2006
Last updated
04/04/2014
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