Individual
KYRSTINA HUDSON MARIOUW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
3290 W BIG BEAVER RD STE 150, TROY, MI 48084-2931
(248) 792-6527
(248) 792-9106
Mailing address
1335 SHEEHAN AVE, ANN ARBOR, MI 48104-3837
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301018301
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/27/2014
Last updated
12/08/2020
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