Individual
ANTONIO SANTA MARIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
555 BRUSH ST APT 1018, DETROIT, MI 48226-4353
(515) 314-9584
Mailing address
555 BRUSH ST APT 1018, DETROIT, MI 48226-4353
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362009601
MI
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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