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Individual

MYA PATRICE NDIAYE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
24420 GRATIOT AVE, EASTPOINTE, MI 48021-3307
(313) 414-1945
(586) 944-2731
Mailing address
24420 GRATIOT AVE, EASTPOINTE, MI 48021-3307
(313) 414-1945
(586) 944-2731

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6301015244
MI
103K00000X
Behavior Analyst
1-17-25043
MI
103TC0700X
Clinical Psychologist
6301015244
MI
171M00000X
Case Manager/Care Coordinator
6301015244
MI

Other

Enumeration date
09/18/2012
Last updated
04/03/2026
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