Individual
JENNIFER EMILY MEDRANO DELACRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20411 W 12 MILE RD STE 101, SOUTHFIELD, MI 48076-6404
(866) 703-1901
Mailing address
20411 W 12 MILE RD STE 101, SOUTHFIELD, MI 48076-6404
(866) 703-1901
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6362009777
MI
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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