Individual
AMANDA JO KLINGENSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
409 PLYMOUTH RD STE 250, PLYMOUTH, MI 48170-1842
(734) 416-9098
Mailing address
409 PLYMOUTH RD STE 250, PLYMOUTH, MI 48170-1842
(734) 416-9098
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301017379
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2016
Last updated
05/10/2018
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