Individual
MR. JEFFERY FOSTER LLEWELLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13101 ALLEN RD, SUITE 100, SOUTHGATE, MI 48195-2216
(734) 785-7705
(734) 785-7731
Mailing address
8463 THORNTREE DR, GROSSE ILE, MI 48138-1587
(734) 785-7705
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301013733
MI
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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