Individual
DR. MARY JANE GAZDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
37211 HARPER AVE STE 3A, CLINTON TWP, MI 48036-3001
(586) 466-7173
(586) 741-0145
Mailing address
37211 HARPER AVE STE 3A, CLINTON TOWNSHIP, MI 48036-3001
(586) 466-7173
(586) 741-0145
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301010567
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E04607
BLUE CROSS/ BLUE SHIELD
MI
Enumeration date
10/16/2006
Last updated
12/12/2023
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