Individual
DR. LOUISE ANNE WELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
340 N MAIN ST STE 200, PLYMOUTH, MI 48170-1250
(734) 335-0028
(734) 335-3931
Mailing address
340 N MAIN ST STE 200, PLYMOUTH, MI 48170-1250
(734) 335-0028
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
016136-1
NY
103TC0700X
Clinical Psychologist
Primary
6301016196
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016136
PSYCHOLOGIST STATE LICENS
NY
01
—
6301016196
LICENSE TO PRACTICE AS PSYCHOLOGIST
MI
Enumeration date
06/09/2006
Last updated
12/06/2023
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