Individual
SHELLEY RAE SYSUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
600 S MAIN ST, EATON RAPIDS, MI 48827-1426
(517) 667-8447
Mailing address
PO BOX 10, MASON, MI 48854-0010
(517) 676-9788
(517) 676-3438
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301010330
MI
Other
Enumeration date
06/13/2006
Last updated
09/27/2012
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