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Individual

DR. DONNA MARIE D. MESZAROS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
40000 GRAND RIVER AVE., SUITE 306, NOVI, MI 48375-2137
(248) 426-9900
(248) 426-9950
Mailing address
6748 ARDSLEY DR, CANTON, MI 48187-3026
(734) 981-5886

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301009817
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0M86060
MEDICARE ID
MI
01
11283595
CAQH
01
68-0-F3-3252-0
BLUE CROSS BLUE SHIELD
MI
Enumeration date
12/05/2006
Last updated
06/07/2008
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