Individual
MRS. ILIANA PANTOLEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
650 GRISWOLD ST, NORTHVILLE, MI 48167-1666
(248) 912-0080
(248) 912-0208
Mailing address
29476 BOBRICH ST, LIVONIA, MI 48152-3404
(248) 946-9351
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301017023
MI
Other
Enumeration date
03/23/2018
Last updated
03/23/2018
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