Individual
KRISTIN DALLAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLP
Contact information
Practice address
1440 TORREY RD STE E, FENTON, MI 48430-1340
(616) 439-0392
Mailing address
117 N RIVER ST STE A, FENTON, MI 48430-3815
(616) 439-0392
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301018325
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/15/2016
Last updated
11/12/2021
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