Individual
JUANITA HOUSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
34841 VETERANS PLZ, WAYNE, MI 48184-1733
(313) 292-7640
Mailing address
14271 STEEL ST, DETROIT, MI 48227-3939
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301016691
MI
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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