Individual
DR. JAY STEPHEN WITHERELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8303 PLATT RD, SALINE, MI 48176-9773
(734) 429-2531
Mailing address
41740 W VILLAGE GREEN BLVD, APT. 204, CANTON, MI 48187-5318
(419) 349-1050
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301015464
MI
Other
Enumeration date
03/28/2013
Last updated
03/28/2013
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