Individual
MARY WEATHERSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
725 S ADAMS RD, STE 244, BIRMINGHAM, MI 48009-6902
(248) 642-2411
Mailing address
725 S ADAMS RD, STE 244, BIRMINGHAM, MI 48009-6902
(248) 642-2411
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301008672
MI
Other
Enumeration date
02/22/2006
Last updated
06/14/2010
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