Individual
MS. SANDRA SUZANNE KUMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
194 E MAIN ST, NORTHVILLE, MI 48167-1620
(248) 719-7671
(248) 719-7563
Mailing address
1857 SCENIC DR, CANTON, MI 48188-1416
(734) 776-2973
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301015779
MI
103TF0000X
Family Psychologist
6301015779
MI
Other
Enumeration date
12/04/2013
Last updated
12/04/2013
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