Individual
JUDY JAIJAETAWAKWE SINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5786 LAKE DR, HASLETT, MI 48840-8436
(517) 862-1267
Mailing address
5786 LAKE DR, HASLETT, MI 48840-8436
(517) 862-1267
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301011292
MI
103TH0004X
Health Psychologist
6301011292
MI
103TP2701X
Group Psychotherapy Psychologist
6301011292
MI
103TR0400X
Rehabilitation Psychologist
6301011292
MI
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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