Individual
MRS. SELINA DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16999 MORRISON ST, SOUTHFIELD, MI 48076-2016
(248) 875-0996
Mailing address
16999 MORRISON ST, SOUTHFIELD, MI 48076-2016
(248) 875-0996
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
—
—
Other
Enumeration date
12/11/2017
Last updated
12/11/2017
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