Individual
DEFNE ELISE ILDIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3722 SUNSET BLVD, ORCHARD LAKE, MI 48324-2957
(609) 721-2350
Mailing address
3722 SUNSET BLVD, ORCHARD LAKE, MI 48324-2957
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.018061
IL
101YM0800X
Mental Health Counselor
6401226114
MI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/17/2023
Last updated
05/06/2026
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