Individual
VICTORIO M. GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
(313) 874-4677
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301009431
MI
103TC0700X
Clinical Psychologist
Primary
6301009431
MI
103TC2200X
Clinical Child & Adolescent Psychologist
6301009431
MI
Other
Enumeration date
01/08/2007
Last updated
04/14/2025
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