Individual
MS. SARA LYNN VAN WORMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLP
Contact information
Practice address
2550 S TELEGRAPH RD, SUITE 250, BLOOMFIELD HILLS, MI 48302-0950
(248) 322-0001
(248) 322-0004
Mailing address
629 FARMDALE ST, FERNDALE, MI 48220-1856
(248) 763-4565
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301011371
MI
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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