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Individual

DR. THOMAS JOSEPH WALTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D., L.P.

Contact information

Practice address
715 CAMBRIDGE ST, YPSILANTI, MI 48197-2127
(734) 340-4043
Mailing address
715 CAMBRIDGE ST, YPSILANTI, MI 48197-2127
(734) 340-4043

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301016487
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6301016487
MICHIGAN PSYCHOLOGY BOARD
MI
Enumeration date
05/07/2010
Last updated
05/15/2021
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