Organization
WENTWORTH AND ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE WENTWORTH (PRESIDENT/CEO)
(586) 997-3153
Entity
Organization
Contact information
Practice address
11111 HALL RD STE 303, UTICA, MI 48317-5726
(586) 997-3153
Mailing address
28871 ALINE DR, WARREN, MI 48093-2690
(586) 307-2137
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301015522
MI
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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