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Individual

LEAH TERIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
50 N PERRY ST, PONTIAC, MI 48342-2217
(248) 338-5833
Mailing address
50 N PERRY ST, PONTIAC, MI 48342-2217

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301015566
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6301015566
PSYCHOLOGY LICENSE #
MI
Enumeration date
05/15/2014
Last updated
07/12/2014
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