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Individual

MICHELLE LEIGH KING DERAMUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
861 N DEAN RD, SUITE D, AUBURN, AL 36830-9420
(334) 887-4343
(334) 887-5656
Mailing address
861 N DEAN RD, SUITE D, AUBURN, AL 36830-9420
(334) 887-4343
(334) 887-5656

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1648
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1648
STATE LICENSE
AL
Enumeration date
11/23/2010
Last updated
12/02/2016
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