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Individual

ALFRED MANSOUR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
5333 MCAULEY DR, YPSILANTI, MI 48197
(734) 712-4162
(734) 712-5056
Mailing address
5333 MCAULEY DR, YPSILANTI, MI 48197-1014
(734) 712-4162
(734) 712-5056

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
6301014783
MI
103TB0200X
Cognitive & Behavioral Psychologist
6301014783
MI
103TC0700X
Clinical Psychologist
Primary
6301016060
MI

Other

Enumeration date
04/01/2013
Last updated
08/09/2018
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