Individual
DR. LAWRENCE T. WENTWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
11111 HALL RD, SUITE 303, UTICA, MI 48317-5711
(586) 997-3153
(586) 997-4956
Mailing address
11111 HALL RD, SUITE 303, UTICA, MI 48317-5711
(586) 997-3153
(586) 997-4956
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301007769
MI
Other
Enumeration date
08/19/2005
Last updated
04/06/2009
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