Individual
MS. KRISTINA MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
28175 HAGGERTY RD, NOVI, MI 48377-2903
(734) 265-0841
Mailing address
30200 TELEGRAPH RD STE 207, BINGHAM FARMS, MI 48025-5711
(248) 712-1129
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401012155
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3434247
—
MI
Enumeration date
12/29/2011
Last updated
01/07/2022
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