Individual
SUSAN GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3601 W 13 MILE RD STE EC, ROYAL OAK, MI 48073-6712
(248) 898-5058
Mailing address
451 S ETON ST, BIRMINGHAM, MI 48009-6524
(248) 721-4716
(734) 207-5326
Taxonomy
Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
Primary
6301013698
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6301013698
BOARD OF PSYCHOLOGY
MI
Enumeration date
06/03/2010
Last updated
08/15/2024
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