Individual
MALISSA WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLP, LPC
Contact information
Practice address
14067 LAKESIDE BLVD N, SHELBY TOWNSHIP, MI 48315-6074
(586) 255-2482
Mailing address
18964 STRONGFORD DR, MACOMB, MI 48044-9700
(586) 255-2482
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401006969
MI
103TC1900X
Counseling Psychologist
630101724
MI
Other
Enumeration date
10/02/2006
Last updated
07/05/2012
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