Individual
LISA KHOURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., ED.S
Contact information
Practice address
19900 E 10 MILE RD STE 102, SAINT CLAIR SHORES, MI 48080-4412
(586) 776-3366
Mailing address
840 BISHOP RD, GROSSE POINTE PARK, MI 48230-1924
(313) 220-0009
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6361002269
MI
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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