Individual
SHAYLA GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
24445 NORTHWESTERN HWY, SOUTHFIELD, MI 48075-6501
(248) 483-7804
Mailing address
22205 MAPLEWOOD DR, SOUTHFIELD, MI 48033-3670
(248) 763-2399
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
63015758
MI
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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