Individual
JOSEPH CHARLES MIFSUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LLP
Contact information
Practice address
20811 KELLY RD, # 103, EASTPOINTE, MI 48021-3139
(586) 445-2210
(586) 445-0700
Mailing address
28000 DEQUINDRE RD, WARREN, MI 48092-2468
(586) 753-0405
(586) 753-0404
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301012406
MI
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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