Individual
VICTOR IP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7375 WOODWARD AVE STE 2800, DETROIT, MI 48202-3157
(313) 710-8744
(855) 568-2494
Mailing address
7375 WOODWARD AVE STE 2800, DETROIT, MI 48202-3157
(313) 710-8744
(855) 568-2494
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6362010047
MI
Other
Enumeration date
06/11/2019
Last updated
01/16/2025
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