Individual
DR. ANN LOUISE DATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
720 W WACKERLY ST, SUITE 4, MIDLAND, MI 48640-2769
(989) 832-2165
(989) 839-4376
Mailing address
PO BOX 2875, MIDLAND, MI 48641-2875
(989) 832-2165
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301009535
MI
Other
Enumeration date
04/11/2007
Last updated
03/16/2021
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