Individual
KENNETH EDWARD GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST
Contact information
Practice address
30665 NORTHWESTERN HWY STE 255, FARMINGTON HILLS, MI 48334-3144
(248) 802-7713
Mailing address
30665 NORTHWESTERN HWY STE 255, FARMINGTON HILLS, MI 48334-3144
(248) 802-7713
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6361007852
MI
Other
Enumeration date
03/26/2019
Last updated
08/07/2023
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