Individual
LAURA ROELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17940 FARMINGTON RD, LIVONIA, MI 48152-4444
(248) 924-4549
Mailing address
46658 GUNNERY DR, CANTON, MI 48187-1692
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6301015264
PSYCHOLOGY
MI
Enumeration date
01/22/2019
Last updated
01/22/2019
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