Individual
CAROL MARIE WASIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA TLLP
Contact information
Practice address
79 W ALEXANDRINE ST, DETROIT, MI 48201-2015
(313) 831-5535
Mailing address
27851 MIDDLE POINTE DR UNIT 112Q, HARRISON TOWNSHIP, MI 48045-6833
(586) 206-9035
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301015170
MI
Other
Enumeration date
02/05/2013
Last updated
11/28/2017
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