Organization
CLARKSTON FAMILY THERAPISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANCIS M DONNELLY PHD (OWNER)
(248) 922-9077
Entity
Organization
Contact information
Practice address
5639 SASHABAW RD, CLARKSTON, MI 48346-3149
(248) 922-9077
(248) 922-9040
Mailing address
5639 SASHABAW RD, CLARKSTON, MI 48346-3149
(248) 922-9077
(248) 922-9040
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
MI
1041C0700X
Clinical Social Worker
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103T00000X
TAXONOMY
MI
01
—
6301006011
LICENSE
MI
01
—
6301009503
LICENSE
MI
01
—
6801068002
LICENSE
MI
Enumeration date
07/23/2012
Last updated
11/29/2012
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