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Individual

CHARLES ANTHONY DECARLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
TLLP

Contact information

Practice address
15127 BAINBRIDGE ST, LIVONIA, MI 48154-3649
(734) 771-5788
Mailing address
15127 BAINBRIDGE ST, LIVONIA, MI 48154-3649
(734) 771-5788

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6362010154APP25
MI

Other

Enumeration date
05/29/2025
Last updated
05/29/2025
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