Individual
DR. JEREL EUGENE DELDOTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
36405 HARPER AVE, CLINTON TOWNSHIP, MI 48035-2957
(586) 791-6060
(586) 791-8211
Mailing address
36405 HARPER AVE, CLINTON TOWNSHIP, MI 48035-2957
(586) 791-6060
(586) 791-8211
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301005951
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
620005726
RR MEDICARE
MI
Enumeration date
04/27/2006
Last updated
03/15/2010
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