Individual
JOHN PORCERELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
300 E MAPLE RD, SUITE 319, BIRMINGHAM, MI 48009-6308
(248) 646-1267
Mailing address
300 E MAPLE RD, SUITE 319, BIRMINGHAM, MI 48009-6308
(248) 646-1267
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007189
MI
Other
Enumeration date
03/29/2007
Last updated
04/29/2008
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