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Individual

JESSA DMYTRYSZYN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSCP

Contact information

Practice address
4160 WOODWARD AVE, 2ND FLOOR, DETROIT, MI 48201-2027
(313) 656-4052
Mailing address
2304 PROGRESS AVE, LINCOLN PARK, MI 48146-4808
(734) 626-1824

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6361003261
MI

Other

Enumeration date
05/28/2015
Last updated
01/07/2021
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