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Individual

DAVISHA OUTEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, TLLP

Contact information

Practice address
882 OAKMAN BLVD, SUITE D, DETROIT, MI 48238-3710
(313) 961-7990
Mailing address
1064 LAKEVIEW ST, WATERFORD, MI 48328-3817

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301015735
MI

Other

Enumeration date
01/15/2014
Last updated
01/15/2014
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