Individual
MATTHEW MACLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
TLLP
Contact information
Practice address
1800 W BIG BEAVER RD, SUITE 150, TROY, MI 48084-3545
(248) 918-5600
Mailing address
1800 W BIG BEAVER RD, SUITE 150, TROY, MI 48084-3545
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301016821
MI
Other
Enumeration date
02/16/2015
Last updated
08/31/2016
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