Individual
MS. SUSAN ELIZABETH BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MS, TLLP
Contact information
Practice address
511 BEAUBIEN ST, DETROIT, MI 48226-4309
(313) 444-7084
Mailing address
296 RIVARD BLVD, GROSSE POINTE, MI 48230-1626
(313) 258-4135
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362009762
MI
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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