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Individual

THOMAS BOTTENFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
19875 BUTTERNUT LN, SOUTHFIELD, MI 48076-1795
(248) 568-3711
(248) 569-9410
Mailing address
30200 TELEGRAPH RD, SUITE 207, BINGHAM FARMS, MI 48025-4502
(248) 712-1129
(248) 569-9410

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007898
MI

Other

Enumeration date
10/02/2014
Last updated
10/02/2014
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