Individual
MARY KATHERINE BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
862 NOTTINGHAM RD APT 2S, GROSSE POINTE PARK, MI 48230-1755
(313) 613-9165
Mailing address
862 NOTTINGHAM RD APT 2S, GROSSE POINTE PARK, MI 48230-1755
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6361007296
MI
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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