Individual
TABITHA MPAMIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
812 E JOLLY RD, LANSING, MI 48910-6818
(517) 449-8470
Mailing address
812 E JOLLY RD, LANSING, MI 48910-6818
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301015764
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
386337733
—
MI
Enumeration date
03/20/2014
Last updated
03/20/2014
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