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Individual

MR. MICHAEL MEDLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A., TLLP

Contact information

Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
14253 SUSANNA ST, LIVONIA, MI 48154-5914
(734) 469-4275

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MI

Other

Enumeration date
02/04/2009
Last updated
04/29/2010
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