Individual
ALLANTE R'REALE BURNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
28175 HAGGERTY RD, NOVI, MI 48377-2903
(734) 489-1615
Mailing address
28175 HAGGERTY RD, NOVI, MI 48377-2903
(734) 489-1615
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
6361007624
MI
103TC0700X
Clinical Psychologist
6301017432
MI
Other
Enumeration date
04/26/2016
Last updated
07/30/2021
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