Individual
MARK GREGORY ISZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
30150 TELEGRAPH RD STE 245, BINGHAM FARMS, MI 48025
(800) 693-1916
(248) 605-3525
Mailing address
6585 LUANA AVE, ALLEN PARK, MI 48101-2404
(773) 991-3661
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071008523
IL
103TC0700X
Clinical Psychologist
Primary
6301014853
MI
Other
Enumeration date
09/09/2011
Last updated
09/20/2018
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