Individual
ELLEN MARY HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
601 JOHN ST STE E352, KALAMAZOO, MI 49007-5341
(269) 341-8986
Mailing address
1 HURLEY PLZ, FLINT, MI 48503-5902
(317) 372-9590
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301019543
MI
103TC0700X
Clinical Psychologist
Primary
6351004656
MI
390200000X
Student in an Organized Health Care Education/Training Program
6351004656
MI
Other
Enumeration date
07/07/2021
Last updated
03/28/2025
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