Individual
MOLLY DIANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
432 CHARLEVOIX ST, CLAWSON, MI 48017-2036
(248) 470-2063
Mailing address
432 CHARLEVOIX ST, CLAWSON, MI 48017-2036
(248) 470-2063
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
11-056
MI
Other
Enumeration date
12/30/2018
Last updated
12/30/2018
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