Individual
AMY CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
44444 HAYES RD, CLINTON TOWNSHIP, MI 48038-7600
(248) 766-8977
Mailing address
336 NORTHWOOD AVE, ROCHESTER, MI 48307-1542
(248) 766-8977
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401012166
MI
Other
Enumeration date
10/03/2011
Last updated
09/13/2018
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