Individual
DR. SUSAN JILL GOTTLIEB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
23800 ORCHARD LAKE RD, SUITE #104, FARMINGTON HILLS, MI 48336-2560
(248) 471-0785
(248) 471-1406
Mailing address
23800 ORCHARD LAKE RD, SUITE #104, FARMINGTON HILLS, MI 48336-2560
(248) 471-0785
(248) 471-1406
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007337
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F33105
BCBSM
MI
Enumeration date
10/02/2006
Last updated
07/08/2007
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