Individual
SANYANI D EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
TLLP
Contact information
Practice address
25438 SAINT JAMES, SOUTHFIELD, MI 48075-1247
(313) 215-0545
Mailing address
PO BOX 44446, DETROIT, MI 48244-0446
(313) 215-0545
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301014230
MI
Other
Enumeration date
09/08/2009
Last updated
09/08/2009
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