Individual
DR. HARRIET J. MALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
30445 NORTHWESTERN HWY, SUITE #240, FARMINGTON HILLS, MI 48334-3158
(248) 538-5045
(248) 538-1801
Mailing address
30445 NORTHWESTERN HWY, STE 310, FARMINGTON HILLS, MI 48334-3102
(248) 538-5045
(248) 538-1801
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401005154
MI
103G00000X
Clinical Neuropsychologist
6301008104
MI
103T00000X
Psychologist
6301008104
MI
103TA0700X
Adult Development & Aging Psychologist
6301008104
MI
103TC0700X
Clinical Psychologist
Primary
6301008104
MI
103TF0000X
Family Psychologist
6301008104
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11643507
CAQH
MI
Enumeration date
10/17/2006
Last updated
04/28/2021
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