Individual
ALICIA A WIDTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, PSYD
Contact information
Practice address
41400 DEQUINDRE RD STE 110, STERLING HEIGHTS, MI 48314-3751
(586) 580-2975
Mailing address
3950 S SHORE DR, COMMERCE TOWNSHIP, MI 48382-4397
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301018162
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/12/2017
Last updated
10/02/2019
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