Individual
MATTHEW DAVID ENSING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LLP
Contact information
Practice address
1050 SILVER DR, TRAVERSE CITY, MI 49684-5749
(231) 947-2255
Mailing address
2140 STANLEY CREEK DR, INTERLOCHEN, MI 49643-9351
(989) 302-0969
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361001715
MI
Other
Enumeration date
10/09/2014
Last updated
03/01/2022
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