Individual
MS. LISA S WITULSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LLP
Contact information
Practice address
570 CLINTON ST, DETROIT, MI 48226-2334
(313) 224-3796
Mailing address
570 CLINTON ST, DETROIT, MI 48226-2334
(313) 224-3796
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301013699
MI
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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