Individual
DR. THERESA I EGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
17336 W 12 MILE RD STE 101, SOUTHFIELD, MI 48076-2113
(586) 610-4006
Mailing address
17336 W 12 MILE RD STE 101, SOUTHFIELD, MI 48076-2113
(586) 610-4006
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301011944
MI
Other
Enumeration date
09/07/2006
Last updated
06/24/2009
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