Individual
MS. TRACY LYNN WEITZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA TLLP
Contact information
Practice address
20300 CIVIC CENTER DR, STE. 303, SOUTHFIELD, MI 48076-4105
(248) 559-8190
(248) 559-8776
Mailing address
20300 CIVIC CENTER DR., STE. 3030, SOUTHFIELD, MI 48076-4169
(248) 559-8190
(248) 559-8776
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
L2082501
MI
Other
Enumeration date
01/23/2012
Last updated
01/23/2012
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