Individual
JACLYN HAMLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.C.P, TLLP
Contact information
Practice address
25501 VAN DYKE AVE, LIFELINE PSYCHIATRIC SERVICES, CENTER LINE, MI 48015-1208
(586) 755-8911
Mailing address
31219 ARROWHEAD ST, SAINT CLAIR SHORES, MI 48082-1208
(248) 275-9067
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301016375
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13642807
CAQH
MI
01
—
630106375
PSYCHOLOGIST TEMPORARY LIMITED LICENSE
MI
Enumeration date
10/26/2015
Last updated
10/30/2015
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